Figure 1
From: Combined milrinone and enteral metoprolol therapy in patients with septic myocardial depression
Institutional hemodynamic protocol. *Fluid resuscitation using crystalloids to cover basal fluid demands (~30 mL/kg per day) and colloids for further fluid loading (guided by responses in stroke volume and cardiac index, arterial and central venous pressure, heart rate, and clinical signs). Colloids hydroxyethyl starch (molecular weight, 130.000; Voluven® 130/0.4; Fresenius Kabi, Graz, Austria) with a dose limitation of 30 mL/kg per day based on the manufacturer's instructions and gelatine (molecular weight, 22.600; Gelofusin®; B. Braun, Melsungen, Germany) without a dose limitation were used. #New-onset tachyarrhythmias, progressive tachycardia of greater than 110 beats per minute despite adequate fluid resuscitation, pulmonary arterial hypertension with new signs of right heart dysfunction, new-onset hyperglycemia (blood sugar of greater than 130 mg/dL) resistant to insulin dosages of greater than 5 IU/hour, new increase in troponin serum concentrations, or progressive deterioration of diastolic or systolic ventricular function. CI, cardiac index; MAP, mean arterial blood pressure; NE, norepinephrine; RBC, red blood cell; ScvO2, central venous oxygen saturation.