ABC | Volume 112, Nº5, May 2019

Brief Communication Hastenteufel et al Continuous intravenous inotropes in ward units Arq Bras Cardiol. 2019; 112(5):573-576 LVAD: left ventricular assist device. 1,0 0,8 0,6 0,4 0,2 0 0 200 400 600 800 Days Proportion of patients Long-term competing outcomes In-hospital clinical outcomes CLINICAL COMPENSATION n = 9 HEART TRANSPLANT OR LVAD IMPLANT n = 14 1 1 10 3 2 2 2 7 WEANED OFF INOTROPE n = 9 DEATH n = 5 BRIDGE TO TRANSPLANT n = 10 BRIDGE TO DECISION n = 7 PALLIATION n = 2 Heart transplantation or LVAD implant Death Survival free from heart transplantation or LVAD implant Figure 1A Figure 1B disturbances, which can be potentially avoided with careful monitoring. Considering the growing HF severity and the inotrope potential as a bridge therapy in hospitalized patients, a contemporary approach to their utilization has been to focus on the safety profile of its use while maintaining the traditional goals of therapy (the ‘until’ therapy), as described by Stevenson. 5 Avoidance of traditional high doses of inotropes, the administration under careful monitoring conditions and strict electrolyte correction strategies may allow broader use of these agents. Conclusions A contemporary, safety-focused approach to the use of low to moderate doses of intravenous inotropic agents in less resource-intensive settings may be feasible, potentially reconfiguring the use of these agents in different scenarios, ranging from bridge therapy to end-of-life palliation. Author contributions Conception and design of the research: Hastenteufel LCT, Clausell N, Domingues FB, Caballero LG, da Silva ERR, Goldraich LA; Acquisition of data: Hastenteufel LCT, Domingues FB, Caballero LG, da Silva ERR; Analysis and interpretation of the data and Statistical analysis: Hastenteufel LCT, Neyeloff JL, Goldraich LA; Writing of the manuscript: Hastenteufel LCT, Clausell N, Goldraich LA; Critical revision of the manuscript for intellectual content: Clausell N, Goldraich LA. 575