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Vasopressors and Inotropes in PICU

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Dr Jesal Sheth, Mumbai    19 January 2018

Vasopressors and inotropes are frequently used lifesaving medicines in very critical children to support heart, blood pressure (BP) and blood fl ow to all vital organs of the body.

There are many infections, like viral, bacterial or noninfectious medical problems like high lung pressures or postoperative cardiac conditions where, for some reasons, heart does not pump out blood well. As a result, BP falls and blood fl ow to all vital organs of the body organs is not maintained, including heart and brain, leading to multiorgan failure and ultimately death.

Inotropes and vasopressers are life-sustaining medicines which support pumping function of heart, maintain BP and preserve blood fl ow to all vital organs like heart, brain, kidney, liver, till underlying disease process reverses, thus preventing damage to further organs.

Commonly used medicines are dopamine, dobutamine, adrenaline, noradrenaline, milrinone and vasopressin.

Trained clinicians, called intensivists, start these medicines with X dose and titrate it up or down depending on goal directed treatment, refl ecting in multiple clinical and biochemical parameters.

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