What is preferred for cardiogenic shock
Adrenaline or not adrenaline?
In cardiogenic shock use of ionotropes are of very little benefit and have not much effect on the outcome. Even then if we use , we go for NE or NE and dobutamine ( increases cardiac contractility) combinations . Epinephrine is associated with more Systemic acidosis , Tachycardia and Dysarrhythmias as compared to the above mentioned drugs.
Norepinephrine is preferred the most followed by dopamine for cardiogenic shock. The use of epinephrine is recommended only in patients who are unresponsive to traditional agents. Undesirable effects if epinephrine is used include an increase in lactate concentration, a potential to produce myocardial ischemia, the development of arrhythmias, and a reduction in splanchnic flow.