Conclusions

Adrenergic vasoconstrictor therapy can be used to restore tissue perfusion pressure, but has little capacity to improve the peripheral distribution of blood flow or cellular oxygen availability. Clinically, after adequate fluid resuscitation, it is generally advisable to commence with dopamine and add norepinephrine or epinephrine if doses of 20 to 25 pg/kg/min fail to raise mean arterial pressure sufficiently. The concurrent administration of dobutamine when using vasopressor agents should be considered to maintain an adequate cardiac output.

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Sleep Apnea

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