Therapeutic Progress—review Xxxv: Therapeutic Progress in Intensive Care—rational Use of Vasoactive and Inotropic Drugs in the Intensive Care Unit

Abstract

Summary Vasoactive (vasodilating and vasoconstricting) and inotropic drugs are widely used in intensive therapy. Major progress in their use in recent years has been due to a greater understanding of the physiological derangements of the critically ill. This progress is the consequence of improved standards of haemodynamic monitoring in the intensive therapy unit (ITU). In addition the introduction of accurate and reliable syringe pumps, to administer small volumes of fluid accurately, has enabled the easy use of drugs to manipulate physiological parameters. An understanding of the basic anatomy and physiology of the cardiovascular system (CVS) is essential to an understanding of the methods used for monitoring and measurement (1). Logical therapeutic interventions follow from consideration of these measured and derived parameters.