Methodology: 3.5/5
Usefulness: 3.5/5
Mathew R, et al. N Engl J Med. 2021 Aug 5;385(6):516-525.
Question and Methods: The authors performed a double-blinded RCT to determine if milrinone was superior to dobutamine for the treatment of cardiogenic shock in the ICU.
Findings: Primary composite outcome occurred in 49% of milrinone group vs 54% in dobutamine group (ARR 0.05 [90% CI -0.09-0.19], RR 0.9 [90% CI 0.69-1.19 p=0.047]).
Limitations: Major limitations of this study include the small sample size, use of composite outcome, and potential for selection bias regarding excluded patients.
Interpretation: Milrinone was not found to be superior to dobutamine for the treatment of cardiogenic shock in the ICU.
