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4.5 - Fluids, Inotropes and Vasopressors, Vasodilators and Anti-hypertensives
from Section 4 - Therapeutic Interventions and Organ Support
- By Ed McIIroy
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 477-491
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Summary

Key Learning Points
1. Try to avoid high chloride-containing solutions as they worsen peri-operative outcomes and, in particular, can cause acute kidney injury.
2. There is currently no evidence to support the use of albumin over crystalloids.
3. Multiple studies have found no evidence of superiority of early goal-directed therapy with dobutamine.
4. Bicarbonate will denature inotropes if infused together.
5. Beta-blocker initiation should be used cautiously in the critical care population but may have benefit in the sickest patients.