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The contractile power of the left ventricle would have increased when inotropic agents were used, and this would make the closing of the valves stronger.
As a positive inotrope levosimendan overcomes the disadvantages of current inotropic agents, being less likely to induce arrhythmia, cause intracellular calcium overload and cell death.
Intravenous positive inotropic agents are commonly used to treat the patients with acute decompensated heart failure due to left ventricular systolic dysfunction.
Logistic regression analysis (Table 3) demonstrated that the risk of postoperative myocardial infarction development was 7 times (OR=7.629, 95%CI 1.448-40.177, p=0.017), IABP need--6.6 times (OR=6.625, 95%CI 1.564-28.069, p=0.01), postoperative inotropic agent need (OR=4.014, 95%CI 1.235-13,047, p=0.021), low cardiac output syndrome (OR=4.159, 95%CI 0.921-18.775, p=0.064) and malignant ventricular arrhythmia (OR=4.653, 95%CI 0.964-22,456, p=0.056) were 4 times greater in nondipper phenomenon patients than in the patients with dipper phenomenon after CABG.
Patient's capillary withdrawal time was prolonged (>5 sec) and were given inotropic agents, vasopressor support and saline challange twice a day (20 cc/kg) Her blood gases were; pH 6,56, pCO2: 104 mmHg, HCO3:9,2 mmol/L, Be:-31,6, lactat: 16,32 mmol/L at her admission.
Throughout HDF, the patient continued to be hypotensive and bradycardic necessitating an increased dose of inotropic agents. Metabolic acidosis was also persistent requiring repeated sodium bicarbonate administration.
The control group was given continuous low flow oxygen inhalation and inotropic agents, and their cardiac stress was also reduced.
Suggested escalating levels of treatment include no treatment for an abnormality on radiography alone; nasal supplemental oxygen for mild hypoxemia; continuous positive airway pressure through face mask for moderate hypoxemia[9] and intubation, mechanical ventilation, and positive end-expiratory pressure for severe hypoxemia; and volume replacement and inotropic agents for hypotension with low cardiac output.
Pimobendan is a phosphodiesterase III inhibitor and calcium channel sensitizer causing a inodilating effect, at reduced myocardial oxygen consumption energy expenditure when compared to other positive inotropic agents as indicated by Fuentes, 2004 and Atkinson et al., 2009 which would explain the effect seen in the present study.
Inotropic agents and broad-spectrum antibiotics were administered under the situation of severe sepsis.
While being on mechanical ventilation, he was given antibiotics, anticonvulsants, inotropic agents, oxygen supplementation, albumin infusion and other supportive management.