Research Article

Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study

Volume: 12 Number: 1 October 28, 2026
TR EN

Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study

Abstract

Objective: To evaluate the safety outcomes associated with short-term low-dose dobutamine initiation in a monitored ward setting compared with initiation in the intensive care unit (ICU) in patients with advanced heart failure. Material and Methods: This retrospective single-center study included 121 patients who received low-dose dobutamine (2.5–5 µg/kg/min for 72 hours) between 2015 and 2025. Patients were classified as ward (n=37) or ICU (n=84). The primary endpoint was life-threatening arrhythmia. Secondary endpoints included new-onset supraventricular arrhythmia and post-treatment hypotension. Results: Life-threatening arrhythmia occurred in 12 patients (9.9%) overall. No events were observed in the ward group (0/37), whereas 12 occurred in the ICU group (12/84, 14.3%) (absolute risk difference −14.3%, 95% CI −23.3 to −3.2; p = 0.017). Supraventricular arrhythmia rates were similar (5.4% vs. 2.4%; p = 0.585). Post-treatment hypotension was more frequent in the ICU group (20.2% vs. 2.7%; p = 0.012). Conclusion: Given the retrospective design, triage-based patient selection, and substantial baseline differences between groups, the findings should be interpreted descriptively and do not establish comparative safety between the ward and ICU groups. In carefully selected patients who do not meet ICU admission criteria, short-term low-dose dobutamine initiation under structured ward monitoring may be feasible, but prospective studies are required to establish its safety.

Keywords

Supporting Institution

NA

Ethical Statement

Ethic Board: was approved by the Antalya Training and Research Hospital Ethics Committee (approval date: 03 July 2025; protocol no. 11/3

Thanks

NO

References

  1. 1. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022;79(17):e263–e421.
  2. 2. Young JB, Moen EK. Outpatient parenteral inotropic therapy for advanced heart failure. J Heart Lung Transplant. 2000;19(8 Suppl):S49–S57.
  3. 3. Jentzer JC, Wiley B, Bennett C, Murphree DH, Keegan MT, Kashani KB, Bell MR, Barsness GW. Temporal trends and clinical outcomes associated with vasopressor and inotrope use in the cardiac intensive care unit. Shock. 2020;53(4):452–9.
  4. 4. Kapur NK, Kanwar M, Sinha SS, Thayer KL, Garan AR, Hernandez-Montfort J, Zhang Y, Li B, Baca P, Dieng F, Harwani NM, Abraham J, Hickey G, Nathan S, Wencker D, Hall S, Schwartzman A, Khalife W, Li S, Mahr C, Kim JH, Vorovich E, Whitehead EH, Blumer V, Burkhoff D. Criteria for defining stages of cardiogenic shock severity. J Am Coll Cardiol. 2022;80(3):185–98.
  5. 5. Basir MB, Schreiber TL, Grines CL, Dixon SR, Moses JW, Maini BS, Khandelwal AK, Ohman EM, O’Neill WW. Effect of early initiation of mechanical circulatory support on survival in cardiogenic shock. Am J Cardiol. 2017;119(6):845–51.
  6. 6. Basir MB, Lemor A, Gorgis S, Taylor AM, Tehrani B, Truesdell AG, Bharadwaj A, Kolski B, Patel K, Gelormini J, Todd J, Lasorda D, Smith C, Riley R, Marso S, Federici R, Kapur NK, O’Neill WW; National Cardiogenic Shock Initiative Investigators. Vasopressors independently associated with mortality in acute myocardial infarction and cardiogenic shock. Catheter Cardiovasc Interv. 2022;99(3):650–7.
  7. 7. Bloom JE, Chan W, Kaye DM, Stub D. State of shock: contemporary vasopressor and inotrope use in cardiogenic shock. J Am Heart Assoc. 2023;12(15):e029787.
  8. 8. Ahmad T, Manohar SA, Stencel JD, Le Jemtel TH. Dobutamine in the management of advanced heart failure. J Clin Med. 2024;13(13):3782.

Details

Primary Language

English

Subjects

Cardiology

Journal Section

Research Article

Publication Date

October 28, 2026

Submission Date

May 22, 2026

Acceptance Date

September 15, 2026

Published in Issue

Year 2026 Volume: 12 Number: 1

APA
Avcı, R., Yılmaz Öztekin, G. M., Erkal, Z., Bayar, N., Erdoğdu, O. U., Ersoysal, M. R., & Arslan, Ş. (2026). Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study. Akdeniz Tıp Dergisi, 12(1). https://doi.org/10.53394/akd.1953988
AMA
1.Avcı R, Yılmaz Öztekin GM, Erkal Z, et al. Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study. Akd Med J. 2026;12(1). doi:10.53394/akd.1953988
Chicago
Avcı, Rauf, Gülsüm Meral Yılmaz Öztekin, Zehra Erkal, et al. 2026. “Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study”. Akdeniz Tıp Dergisi 12 (1). https://doi.org/10.53394/akd.1953988.
EndNote
Avcı R, Yılmaz Öztekin GM, Erkal Z, Bayar N, Erdoğdu OU, Ersoysal MR, Arslan Ş (October 1, 2026) Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study. Akdeniz Tıp Dergisi 12 1
IEEE
[1]R. Avcı et al., “Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study”, Akd Med J, vol. 12, no. 1, Oct. 2026, doi: 10.53394/akd.1953988.
ISNAD
Avcı, Rauf - Yılmaz Öztekin, Gülsüm Meral - Erkal, Zehra - Bayar, Nermin - Erdoğdu, Onur Umut - Ersoysal, Muhammed Ridvan - Arslan, Şakir. “Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study”. Akdeniz Tıp Dergisi 12/1 (October 1, 2026). https://doi.org/10.53394/akd.1953988.
JAMA
1.Avcı R, Yılmaz Öztekin GM, Erkal Z, Bayar N, Erdoğdu OU, Ersoysal MR, Arslan Ş. Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study. Akd Med J. 2026;12. doi:10.53394/akd.1953988.
MLA
Avcı, Rauf, et al. “Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study”. Akdeniz Tıp Dergisi, vol. 12, no. 1, Oct. 2026, doi:10.53394/akd.1953988.
Vancouver
1.Rauf Avcı, Gülsüm Meral Yılmaz Öztekin, Zehra Erkal, Nermin Bayar, Onur Umut Erdoğdu, Muhammed Ridvan Ersoysal, Şakir Arslan. Ward-Based Initiation of Low-Dose Dobutamine in Advanced Heart Failure: A Retrospective Descriptive Study. Akd Med J. 2026 Oct. 1;12(1). doi:10.53394/akd.1953988