Hemodynamic Insufficiency

I was just using StumbleUpon, and came on a page of Critical Care tutorials which included this:

If hemodynamic insufficiency is caused by vasoplegia (pathological vasodilation), fluid depletion or sequestration or low stroke volume, the initial intervention is usually to fluid load. If an acute ischemia event has occurred, revascularization by PTCA (angioplasty) or thrombolysis is indicated (1). If there is a significant amount of non functioning, stunned or hibernating myocardium, intra-aortic balloon counterpulsation may be utilized – perfusing the brain and coronary arteries in diastole (2). Norepinephrine may be used to raise diastolic blood pressure and thus improve coronary artery perfusion. If the patient is vasoplegic, following fluid resuscitation, a vasopressor such as dopamine, norepinephrine, epinephrine or phenylephrine is administered. If a potent inotrope is required, to improve cardiac contractility, dobutamine is the most effective drug. In patients with hypotension, cause unknown, epinephrine will re-establish a circulation, with the cost of perhaps worsening a lactic acidosis and reducing gut perfusion.

I don't really understand this -- its just a hobby -- but the parts that I understand, I really like. Because I love knowing things like this, and because treating the body as a series of interconnected systems whose performance can be measured, evaluated, and, if necessary, corrected -- just makes so much sense to me.

Oh, and what I think thats saying is, if blood pressure isn't high enough,you want to get blood in there, pronto, and you might have to physically open paths via a 'sewer snake' or drugs.

I think.