Cardiogenic Shock | LVF | RVF
Last modified: 14 October 2021, 2:13:31 PM AEDT
Management (Both LVF/RVF)1 / 5
- correct hypovolaemia
- ⬇PEEP (⬆VR)
- exclude = tamponade + PTX
- inotrope
- vasoC / vasoD
- mechanical support
- IABP
- LVAD
- ECMO
Management (LVF)2 / 5
- reduce afterload
- GTN
- Hydralazine
Management (RVF)3 / 5
- systemic arterial vasoC / maintain adequate coronary BQ
- NAd / vasopressin
- too much ⮕ ⬆AL ⬆MRO2
- vasopressin (systemic vasoC, sparing of pulmonary BV)
- pulmonary arterial vasoD = ⬇PVR ⬇afterload
- iNO = inhaled NO
- milrinone
- PO sildenafil
- prostaglandins = ⬆NO release
- non-specific vasoD
- cost = ⬇coronary BQ
- SNP, GTN, hydralazine
- levosimendan
- ⬇PVR, ⬆RVEF
Management (Diastolic failure)4 / 5
- lusitropic agent (⬇ventricular relaxation)
- milrinone