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Inotropes, Vasopressors and Vasodilators

  • Nandor MarczinEmail author
  • Paola Carmona
  • Steffen Rex
  • Eric E. C. de Waal
Chapter
  • 17 Downloads

Abstract

Indications, selection and duration of inotropic support during and following cardiac surgery remain variable and controversial. Nevertheless, it is employed frequently for anticipated or manifest hemodynamic instability ranging from low cardiac output to established shock stages. This chapter provides a background, justification and overview of inotropic and vasopressor therapy with a strong clinical rather than molecular and pharmacological focus. Current treatment strategies and principles of crucial aspects of medical management are discussed. The main clinical classification of inotropes and to a lesser degree vasoactive agents is included as well as clinical utilities of the most frequently used agents are described. Due to the significance of right ventricular dysfunction a section is dedicated to the right ventricle and pulmonary circulation. Finally, a summary of treatment strategies for the most common clinical scenarios is provided.

Keywords

Hypotension Low cardiac output Inotropes Inopressors Inodilators Inhaled nitric oxide 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Nandor Marczin
    • 1
    • 2
    • 3
    Email author
  • Paola Carmona
    • 4
  • Steffen Rex
    • 5
    • 6
  • Eric E. C. de Waal
    • 7
  1. 1.Section of Anaesthesia, Pain Medicine and Intensive CareImperial CollegeLondonUK
  2. 2.Department of AnaesthesiaThe Royal Brompton and Harefield NHS Foundation TrustHarefieldUK
  3. 3.Department of Anaesthesia and Intensive CareSemmelweis UniversityBudapestHungary
  4. 4.Anaesthesia, Critical Care and Pain Medicine DepartmentConsorcio Hospital General of ValenciaValenciaSpain
  5. 5.Department of AnesthesiologyUniversity Hospitals LeuvenLeuvenBelgium
  6. 6.Department of Cardiovascular SciencesKU LeuvenLeuvenBelgium
  7. 7.Department of AnesthesiologyUniversity Medical Centre UtrechtUtrechtThe Netherlands

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