CAPITAL DOREMI 2 Comparing Inotrope Medications and Placebo for Treating Cardiogenic Shock in ICU Patients

What this Trial Is About

Researchers are studying the use of medications called inotropes, which aim to increase the hearts pumping ability, in critically ill patients admitted to the Cardiac Intensive Care Unit with cardiogenic shock. Cardiogenic shock is a serious condition caused by the hearts inability to pump enough blood, commonly due to acute heart attacks, and it has a high risk of death. This trial seeks to determine whether inotropes improve outcomes or potentially cause harm, as previous studies showed uncertain benefits and possible risks. Participants will be randomly assigned to receive either one of two common inotropes used in Canada, Milrinone or Dobutamine, or a placebo normal saline in a double-blind setup. Doses of the inotropes will start at standard levels and be adjusted based on each patients condition by their doctors. After 12 hours, treatment becomes open-label, allowing doctors to continue or stop inotropes as needed. The study compares these therapies during initial resuscitation in patients classified as SCAI class C or D cardiogenic shock. During the study, patients will be closely monitored with assessments including clinical exams and adjustments to medication doses. Researchers will track outcomes such as mortality, kidney failure needing dialysis, need for heart transplant or mechanical support, heart rhythm problems, cardiac arrest, heart attacks, and strokes during hospitalization, up to 12 weeks. The trial involves multiple centers and aims to provide clear evidence on the use of inotropes in this critical care setting.

CAPITAL DOREMI 2: Inotrope Versus Placebo Therapy for Cardiogenic Shock