LAS VEGAS—Managing profound hypotension in the critically ill can be complex. Peter M. DeBlieux, MD, FACEP, urged attendees to apply situational awareness—avoiding a “fixed recipe” dogmatic approach to these patients.
Dr. DeBlieux, a Louisiana State University Health Science Center, professor of emergency medicine and professor of pulmonary and critical care medicine in New Orleans, shared his experiences on common treatment plans for cardiogenic, obstructive, septic, and spinal shock. He also noted the surprisingly limited science supporting the complex treatment and management of these patients.
For the patient in cardiogenic shock presenting with primary pump failure, limited cardiac output, reduced coronary perfusion pressure with reduced mean arterial blood pressure (MABP), and increased heart rate corresponding to raised myocardial oxygen demand, the first line of defense is dobutamine, said Dr. DeBlieux.