Successful treatment with inotropes and vasopressors depends on an understanding of the interplay of flow, pressure, and resistance in the cardiovascular system and an appreciation of the pathophysiologic mechanisms leading to inadequate tissue perfusion. Any treatment strategy is necessarily a compromise between the requirements of different vascular beds. Furthermore, the underlying hemodynamic derangements can change rapidly. Therefore, inotropes and vasopressors should be titrated to measures of improved hemodynamic status, and the treatments should be frequently reviewed.
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