adrenaline + noradrenaline + dopamine + dobutamine

This combination consists of four traditional catecholamine inotropic and vasopressor agents: adrenaline (epinephrine), noradrenaline (norepinephrine), dopamine, and dobutamine. These agents are used perioperatively to support cardiac output and maintain hemodynamic stability in patients with low ejection fraction (typically <35%) undergoing cardiac surgery, such as coronary artery bypass grafting (CABG) or valve surgery. Adrenaline and noradrenaline act on alpha- and beta-adrenergic receptors to increase heart rate, contractility, and systemic vascular resistance. Dopamine acts on dopaminergic and adrenergic receptors in a dose-dependent manner, while dobutamine is a synthetic catecholamine that primarily targets beta-1 adrenergic receptors to enhance myocardial contractility. In clinical research, this combination is often used as a standard-of-care comparator against newer agents like levosimendan.

Other names

epinephrine + norepinephrine + dopamine + dobutaminetraditional inotropes