Inotropes and vasopressores - Cardiff PICU

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Dopamine◦ Precursor of noradrenaline.◦ α 1 , β 1 , β 2 , DA 1 , DA 2 receptors.◦ 5 – 15 mcg/kg/min β1 effectsdominate◦ > 15α1 becomeimportant◦ > 25α1 dominates◦ ‘Renal dose’ concept obsolete
Adrenaline◦ α 1 , β 1 , β 2 .◦ 0.05 – 0.3 µg/kg/min β 1, 2 > α 1 ,• β 2 effects may cause balanced effect on SVR.◦ 0.3 – 1 µg/kg/min β 1, 2 = α 1◦ > 1 µg/kg/min β 1, 2< α 1◦ Disadvantage - increase in myocardial O 2 dem<strong>and</strong><strong>and</strong> arrythmias
Page 2: Definition of ShockInadequate oxyge
Page 5 and 6: Physiology◦ Adult Oxygen demand 1
Page 7 and 8: Compensation◦ Increase cardiac ou
Page 9 and 10: Pathophysiology of Sepsis◦ Endoth
Page 12 and 13: A brief history of septic shock tre
Page 15: The search for a magic bulletFew Ra
Page 20 and 21: esolve 28-day MortalityAdditional S
Page 22 and 23: Shock:GastroenteritisAbdo obstructi
Page 24 and 25: Role of early fluid resuscitation i
Page 26 and 27: RESULTS.34 patients (median age, 13
Page 28: 7000 critically ill adults
Page 33 and 34: Inotropes and pressors
Page 35 and 36: When to start inotropes◦ Sepsis -
Page 37 and 38: Choice of inotrope◦ Personal pref
Page 39: Receptor2 ndmessengerActionsα 1IP
Page 43 and 44: Dobutamine◦ Synthetic mixture of
Page 45 and 46: Phosphodiesterase inhibitors◦ Eno
Page 48 and 49: Vasopressin◦ Injection in humans
Page 50 and 51: Goal targeted treatment
Page 53 and 54: Largest mortality benefit of any se
Page 62: Does it work?
Page 66: Mortality associated with CV O 2sat
Page 69 and 70: Pitfalls
Page 71 and 72: Common errors (1)◦ Failure to est
Page 73 and 74: Common errors (2)◦ Inadequate flu
Page 75 and 76: Common errors (3)◦ KCl boluses◦

Inotropes and vasopressores - Cardiff PICU

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