Critical Care Time 36. Inotropes
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Nov 4, 2024 Dive into the fascinating world of inotropes, key players in managing cardiogenic shock. Discover how different inotropic agents, like catecholamines, enhance cardiac performance and the importance of calcium in critical care. Unravel the complexities of cardiac output and hemodynamics while navigating real-life case studies, including challenging scenarios like pulmonary embolism. Learn to differentiate between inotropes and ionotropes, and get insights into effective pacing strategies. Join a lively discussion that blends education and engagement!
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Inotropes and Cardiac Output
- Inotropes alter cardiac contraction force, affecting stroke volume and heart rate.
- Some inotropes increase afterload (vasoconstrictors), while others decrease it (vasodilators).
Types of Inotropes
- Inotropes include catecholamines (e.g., dobutamine), phosphodiesterase inhibitors (e.g., milrinone), and other agents (e.g., angiotensin-2).
- Calcium is vital for inotrope function and can itself act as an inotrope, especially in hypocalcemic patients.
Epinephrine's Mechanism and Effects
- Epinephrine, a catecholamine, increases heart rate (chronotropy) and force of contraction (inotropy).
- It also causes vasodilation via cyclic AMP and vasoconstriction via alpha-1 receptors, demonstrating varying effects depending on receptor interaction.