Vasopressors and Inotropes
Vasopressors and Inotropes
Vasopressors and Inotropes
Inotropes
Critical Care Lecture Series
ICU
Objectives
What are the different classes of shock and
give examples of each.
Discuss how to investigate and the
management principles behind each of the
causes of shock.
What are the different crystalloids and colloids
available for resuscitation?
Have knowledge of the mechanism of action of
commonly used vasopressors and inotropes,
including dopamine, dobutamine, milnerone,
levophed, phenylephrine, epinephrine,
vasopressin
Discuss adverse events associated with the
above agents.
ICU
Is My Patient in Shock?
Definition of shock
Inadequate end organ perfusion leading
to inadequate oxygen delivery
N.B. a patient in shock does not have
to be hypotensive
ICU
Treatment of Shock
ICU
Basic Resuscitation:
ABCDE’s
A: Airway establishment
B: Breathing: control WOB
C(a): Circulation Optimization
C(b): Control O2 consumption
D: Delivery of O2 adequately
E Extraction of O2
ICU
Fluid resuscitation
Very important….
Therapy with least detrimental effects
Fluid therapy may be beneficial in any
type of shock
Even cardiogenic shock/pulmonary
edema
ICU
Fluid Resusitation
β1 agonist/stimulation: chronitropic,
inotropic
β2 agonist/stimulation: vasodilation,
bronchodilation
α: vasoconstriction
D: increases renal blood flow
ICU Vasopressors and inotropes:
the chart (everything you need to know)
Cardiac Output
ICU
Dopamine
Cardiac Output
ICU
Overview of the
ICU Management of Shock
ICU
Case Study
65 yo male presents to ED
Complaining of cough and feeling
very unwell
HR 120, BP 100/60, RR 30, temp 39
Is this patient in shock?
What investigations
What treatment would you start?
ICU
Case Study