The drugs of choice vary from cardiologist to cardiologist and they will argue with the Vascular surgeons. Usually Epinephrine or dobutamine has been used in the patients I have cared for due to the increase of cardiac output and stroke volume benefits at much lower dosage. What was the Flight nurses drug of choice?
Cardiogenic Shock Treatment & Management
Dopamine, norepinephrine, and epinephrine are vasoconstricting drugs that help maintain adequate blood pressure during life-threatening hypotension and help preserve perfusion pressure for optimizing flow in various organs. The mean blood pressure required for adequate splanchnic and renal perfusion (mean arterial pressure [MAP] of 60 or 65 mm Hg) is based on clinical indices of organ function.
In patients with inadequate tissue perfusion and adequate intravascular volume, initiation of inotropic and/or vasopressor drug therapy may be necessary. Dopamine increases myocardial contractility and supports the blood pressure; however, it may increase myocardial oxygen demand. Dobutamine may be preferable if the systolic blood pressure is higher than 80 mm Hg and has the advantage of not affecting myocardial oxygen demand as much as dopamine. However, the resulting tachycardia may preclude the use of this inotropic agent in some patients. Epinephrine can increase the MAP by increasing the cardiac index and stroke volume, along with an increase in SVR and heart rate.
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