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In this podcast we are going to be talking about inotropes and vasopressors. And we’re going to be talking about them with respect to septic shock. In the UK we use the definition of septic shock as a patient who is hypotensive following the administration of 30 mils per kilo of IV fluids. You might wonder why we can’t continue giving these patients more and more IV fluids, but as with most things in medicine there are side effects and consequences to this. This fluid (and even more so in sepsis) is going to moving from the intravascular space to other fluid compartments and can give rise to problems such as pulmonary oedema. Inotropes and vasopressors in themselves are not harmless but they do have a role in supporting the cardiovascular system in haemodynamic compromise and the surviving sepsis campaign would ask us to consider them went 30 mils per kilo has been administered to patients without the resultant rise in BP..... |