Hypotension management

[surya24]

If any non cardiac fluid overload pt on ventilator how to manage hypotension? Please answer step by step like 1st inj. Norad then vaso then... Like that

 

[drankur]

this is very generalised quesiton, we need to find the cause of hypotension (shock) and manage accordingly

 

[pankajpunj]

Let us try to solve this :
First of all why the patient is in hypotension inspite of having good cardiac function and good intravascular volume
Distributive shock eg septic shock in which there will be third space loss this will need fluid challenge followed by norepi infusion. Anaphylactic shock will need inj adrenaline 1:10000 IM every 5-10 mins
Obstructive shock eg massive pulmonary embolism but in this case cardiac output will be reduced and there will be pulm congestion this will need different treatment. If it is aortic causes may need IABP.

Can you post history and the preceding events which lead pt to be on ventilator