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DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
DETROIT CARDIOGENIC SHOCK ... INITIATIVE ALGORITHM ... vasopressors or inotropes ... #Algorithm #DCSI ... Initiative #Management #Cardiology
Pressors and Inotropes

Norepinephrine
 • alpha1 > beta 1
 • Increase SVR > Inotropy
Vasopressin
 • V1
 •
Pressors and Inotropes ... Increase SVR > Inotropy ... 2, alpha 1 • Inotropy ... inhibitor • Inotropy ... pharmacology #comparison #shock
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
essentially Cardiogenic Shock ... patients need inotrope ... #differential #algorithm ... #management #cardiology
Cardiogenic Shock algorithm #algorithm #cardiology #cardiogenicshock #criticalcare #algorithm
Cardiogenic Shock ... algorithm #algorithm ... #cardiology #cardiogenicshock ... #criticalcare #algorithm
Vasopressors and Inotropes - Pharmacology Summary
Vasopressors
Phenylephrine (alpha-1)
 • Increases BP, SVR
 • Risk of reflex bradycardia
Vasopressors and Inotropes ... first agent in shock ... line in septic shock ... Increases BP, SVR, not inotropic ... #Vasopressors #Inotropes
Common Vasopressors and Inotropes
Norepinephrine (NE)
 - Indication: Distributive shock (1st line for septic shock), Cardiogenic shock
Vasopressors and Inotropes ... : Distributive shock ... ), Cardiogenic shock ... , Shock where ↑ ... #Vasopressors #Inotropes
Vasopressors and Inotropes
 • Norepinephrine - Levophed - "Levo" - Generally thought of as the first
Vasopressors and Inotropes ... pressor added in shock ... in refractory shock ... in setting of shock ... #Vasopressors #Inotropes
Calcium Channel Blockers - Dihydropyridines vs Non-Dihydropyridines
Dihydropyridines (amlodipine, felodipine, nifedipine, nicardipine)
 • SVR: Decrease
 • Inotropy:
SVR: Decrease • Inotropy ... SVR: Decrease • Inotropy ... comparison #table #cardiology
Shock - Pathophysiology 
Inadequate tissue perfusion to meet O2, nutrient requirements
1. Distributive Shock
2. Hypovolemic Shock
3. Cardiogenic
Shock - Pathophysiology ... Distributive Shock ... Hypovolemic Shock ... Cardiogenic Shock ... differential #diagnosis #algorithm
Initial Evaluation and Management of Septic Shock - Algorithm

Landsberg Manual @LandsbergManual - https://amzn.to/3rEtbK8

#Septic #Shock #Sepsis #management
Management of Septic Shock ... - Algorithm Landsberg ... 3rEtbK8 #Septic #Shock ... management #diagnosis #Algorithm