Inotropic Therapy
• A trial of dobutamine infusion up to 20 micrograms/kg/minbe administered or added to vasopressor (if in use) in the presence of (a) myocardial dysfunction as suggested by elevated cardiac filling pressures and low cardiac output, or (b) ongoing signs of hypoperfusion, despite achieving adequate intravascular volume and adequate MAP (grade 1C).
• Not using a strategy to increase cardiac index to predetermined supranormal levels (grade 1B).