Clinics in chest medicine
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Hemodynamic support during sepsis should focus on aggressive resuscitation coupled with vasopressors aimed at restoration of blood pressure and end-organ perfusion and preservation. The choice of vasopressors should be based on the degree and persistence of peripheral vasodilatation as well as the degree of cardiac stimulation required. ⋯ Dopamine's role of renovascular preservation remains controversial. Therapeutic strategies aimed at supranormal improvements in cardiac index or oxygen delivery have no documented effect in septic patients and should not be part of their therapy.
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Cardiac dysfunction is common in sepsis and septic shock. An understanding of this pathophysiology is crucial in treatment of this disorder. This article reviews the numerous studies of septic shock in humans that focus on cardiovascular physiology, briefly addresses the possible etiology, and concludes with therapeutic implications.