Inotropic Therapy in Acute Circulatory Failure
Various definitions of “acute circulatory failure” (ACF) can be given according to the criteria considered as most meaningful (cardiac output, systemic pressures or others). In this article, we will define ACF in terms of inappropriate peripheral (tissular or even better, cellular) oxygen supply. This definition has the advantage to clearly specify that the therapy has to aim to improvement of oxygen tissular delivery, i.e. to optimization of arterial O2 content and O2 transport. Optimization of arterial O2 content is not the subject of this discussion, but O2 transport is the basis of our topic. O2 transport does not only depend on cardiac output: considerations about microcirculation and rheology would be here of primary importance but, once again, fall outside our topic. In treating ACF we have to take into account the quality of tissular perfusion.
KeywordsPulmonary Vascular Resistance Inotropic Agent Adrenergic Agonist Severe Congestive Heart Failure Ventricular Filling Pressure
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