Key result
Neonatal cardiotonic use remains widespread despite lacking evidence for dosing, efficacy, and safety.
This review highlights the lack of evidence-based knowledge and age-appropriate formulations for cardiotonic drugs in neonates, emphasizing the need for robust future trials.
This overview provides a summary of the commonly used vasoactive agents and the various clinical scenarios in which they are used in the neonatal intensive care unit (NICU). The lack of well-designed clinical trials in this vulnerable population means that these agents continue to be administered without sufficient evidence-based knowledge on their dosing, safety, efficacy and long-term effects. The lack of age appropriate cardiotonic formulations remains an ongoing challenge. Future trials of cardiotonic drugs need to incorporate echocardiography and other objective monitoring tools in their design with robust assessments of short and longer-term outcomes.
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Stapleton et al. (2026) conducted a review in Neonates requiring vasoactive agents. Cardiotonic drugs was evaluated. Cardiotonic drugs are commonly administered to neonates in the intensive care unit without sufficient evidence-based knowledge regarding their dosing, safety, efficacy, and long-term effects.
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