The force of contraction of the cardiac muscle depends on a number of factors. Myocardial performance can be affected by intrinsic and extrinsic factors, including catecholamines, inotropes, shortening of refractory period, calcium ions, digitalis, and atrial filling. The principle of therapy should be directed towards treating arrhythmias and controlling heart rate. The controlled use of inotropes and vasodilators can then be considered. Vasoactive drugs used in the ICU can have more than one action and should be used selectively (Iable3).
than one action and should be used selectively (Iable3).
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