Cardiogenic shock |


    • ACLS says

      When a child has fluid-refractory shock and presents with signs of poor perfusion and hypotension with vasoconstriction (mottled skin, delayed capillary refill), vasoactive medications should be used to improve blood pressure by increasing myocardial contractility with minimal vasoconstriction.

      The vasoactive medication of choice for fluid refractory “cold” shock is epinephrine.

      The infusion rate should be 0.03-0.2 mcg/kg/min. This should be titrated to support blood pressure and systemic perfusion. Remember: higher infusion rates of epinephrine can increase systemic vascular resistance, therefore the infusion rates should ideally be kept lower than .3 mcg/kg/min. If blood pressure is adequate and persistent signs of shock are present Milrinone may improve cardiac output and produce some vasodilation.

  1. Gehan Hussein says

    very informative , i need further information about post operative pediatric cardiac surgery cardiogenic shock and role of pediatrician in treatment to reduce mortality

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