Table: Inotropic Agents Used in ICU Agent Standard Infusion Noradrenaline 6 mg / 100 ml 5% dextrose   First line drug in septic shock Maintenance of blood pressure Adrenaline 6 mg / 100 ml 5% dextrose       Cardiopulmonary resuscitation Acute severe asthma Anaphylaxis Cardiogenic shock Maintenance of blood pressure Medical pacing Dobutamine 500 mg / 100 ml 5% dextrose    Primarily a vasodilator, weak inotropic action Traditionally used in cardiogenic shock or low output, high afterload states or when filling pressures high Often used in combination with noradrenaline Dopamine 400 mg / 100ml 5% dextrose (ml/hr approx µg/kg/min)     Maintenance of blood pressure No advantage over adrenaline/noradrenaline “Renal dose” dopamine is not used Endocrine side effects Isoprenaline 6 mg / 100 ml 5% dextrose   Vasodilator, chronotrope (rarely used) Symptomatic bradycardia Levosimendan 12.5 mg / 250 mL 5% dextrose Loading dose: 6-12µg/kg/10min Infusion: 0.05-0.2 µg/kg/min NB: Loading dose may cause marked hypotension, may be omitted or reduced.   Calcium sensitizer Increases myocardial contractility in an oxygen efficient manner and dilates coronary and systemic vessels Role in Intensive Care not established 10mg / 100 ml 5% dextrose Loading dose: 50µg/kg/20 min Infusion: 0.5 µg/kg/min*   Milrinone (ml/hr = µg/min) (ml/hr = µg/min) (ml/hr approx µg/kg/min) (ml/hr = µg/min) *Standard milrinone prescription for 70 kg patient: Uses   Cardiogenic shock due to diastolic failure Pulmonary hypertension following valve replacement Catecholamine induced down regulation Loading dose: 3500 µg = 35 ml over 20 minutes Maintenance: 2100 µg/hr = 20 ml/hr.