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Inotropes and Vasopressors in the CT ICU: Getting the Mixture Right

  • Allison DaltonEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Following cardiac surgery many patients require hemodynamic assistance with inotropic or vasoconstrictive support. The most commonly used inotropes are catecholamines, but phosphodiesterase inhibitors or calcium sensitizers have been shown to be effective and indicated in specific patients. For patients with postoperative vasoplegic shock, catecholamines function as vasopressors to increase systemic vascular resistance and mean arterial pressure. In catecholamine resistant shock, vasopressin may be utilized. In severe, life-threatening shock, methylene blue has shown efficacy in improving hemodynamics and decreasing need for vasoconstrictors.

Keywords

Inotrope Vasopressor Low cardiac output state Cardiogenic shock Vasoplegia Cardiac surgery 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Anesthesia & Critical CareUniversity of ChicagoChicagoUSA

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