Cardiogenicintro7 min
Cold and wet after the infarct
Handover
Anterior STEMI, door-to-balloon three hours ago, stent in the mid-LAD. He is cool from the knees down, the lungs are wet, and urine has been 15 mL for the last hour. RHC: RA 14, PCWP 26, CO 2.6, CPO 0.37 W. This is Forrester cold-wet. The fellow has a fluid bag in hand ‘for the kidneys.’
Untreated tamponade, massive PE, or a crashed CPO/PAPi will keep dropping MAP and climbing lactate. Name the tracing, then move.
Goals
- · CO ≥ 3.4 L/min
- · PCWP ≤ 20
- · Inotrope started