Pocket Pediatrics: The Massachusetts General Hospital for Children Handbook of Pediatrics (Pocket Notebook Series), 2 Ed.

INOTROPES, CHRONOTROPES, AND VASOPRESSORS

Pediatric Shock Differs from Adults (Crit Care Clin 1997;13:553)

• –½ children will change hemodynamics w/i 24 hr, requiring a re-evaluation of therapy

Choice of Cardiovascular Agents

• α₁ = vasoconstriction, ↑ duration of cardiac contraction

• β₁ = ↑ inotropy and chronotropy, β₂ = vasodilation, bronchodilation

• DA = renal, splanchnic, coronary, cerebral vasodilation

• PDEIII inhibition = ↑ inotropy, minimal chronotropy, vasodilation

Table adapted with permission courtesy of R. Scott Harris, MD.

Management of Septic Shock

Adapted from Crit Care Med 2009;37:666.