Thursday, November 19, 2015

Q: Exclusively from hemodynamic perspective, which level of systemic vascular resistance (SVR) is acceptable to avoid organ damage from excessive vasoconstriction?


Answer: 1300 dynes x sec/cm5

During management of "shock", the appropriate mean arterial pressure (MAP) to protect organs is around 65 mmHg. Vasopressors are routinely used to achieve this MAP but simultaneously over use of vasoconstrictors may expose organs to ischemia. If pulmonary artery catheter is in place, keeping systemic vascular resistance (SVR) below 1300 dynes x sec/cm5 is usually safe.


Reference:

Redl-Wenzl EM, Armbruster C, Edelmann G, et al. The effects of norepinephrine on hemodynamics and renal function in severe septic shock states. Intensive Care Med 1993; 19:151.

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