ICU Cases · Applied pharmacology
The vasoactive choice in the septic shock with the cardiac dysfunction
A long case on the vasoactive choice — the noradrenaline first-line, the vasopressin adjunct, the dobutamine for the low CO, the milrinone for the right-heart.
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Prompt
A long case on the vasoactive choice — the noradrenaline first-line, the vasopressin adjunct, the dobutamine for the low CO, the milrinone for the right-heart.
Presentation
A 60-year-old man in the septic shock has the MAP of 58 on the noradrenaline 0.5 mcg/kg/min, the lactate of 4.5, the SvO2 of 62 per cent (the low — the inadequate delivery), and the echo shows the biventricular dysfunction (the EF of 35 per cent). The CVP is 14, the cardiac index is 2.2 L/min/m2 (the low).[1]
References2ShowHide
- [1]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [2]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.