Tx for PE + hypotension

[Summit]

The low MAP didn't come from vascular tone problem or a volume problem initially, but effectively, because of the blockage, a MAP could be maintained with pressors. Yes, it doesn't address the underlying cause, but maybe it holds out until you can address it.

 

[VFlutter]

My thought process for the use of pressors would be to get the most out of what you have. If you have a reduced blood return to the LV then you want to get as much of that out with each pump. Giving pressors increases force of contraction. As I said, It wouldn't really help in any significant way.

 

[usalsfyre]

Giving pressors increases force of contraction

Might want to check your mechanism of action, pressors will actually decrease ino and chronotropy.

Volume and/or pressors are a "gotta do something" move. It's easily to academically discuss the fact it won't work. It's a bit harder with a peri-arrest patient on your cot.

 

[VFlutter]

Might want to check your mechanism of action, pressors will actually decrease ino and chronotropy.

I should have said inotropes instead of pressors. I was thinking dopa/dobut

 

[Veneficus]

Might want to check your mechanism of action, pressors will actually decrease ino and chronotropy.

Volume and/or pressors are a "gotta do something" move. It's easily to academically discuss the fact it won't work. It's a bit harder with a peri-arrest patient on your cot.

Sometimes you simply must accept there is nothing you can do.

Medicine is not simply knowledge, it is the ability to use that knowledge to change something.

But no matter how much ability we have, we cannot win every game. We do not choose the board, we do not choose the pieces, and the antagonist often has years of head start. But we still play.

Pissing in the ocean trying to make it turn yellow is doing something. But it will never work.

Pick your battles and save your energy for the games you have a chance at. You will sleep easier.