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Forester Hemodynamic Subsets and Therapy

Subset I
1. Normal
  1. Warm and Dry
    1. Optimize Oral medications
    2. PCWP 15-18 and CI >2.2
Subset II
1. Congestion
  1. Warm and Wet
    1. Pulmonary/Peripheral Congestion
      1. PCWP >18 AND CI >2.2
        IV diuretics
        IV vasodilators
Subset III
1. Hypoperfused
  1. Cold and Dry
    1. PCWP 15-18 and CI>2.2
      1. IF PCWP <15 --IVF until 15-18
        IF PCWP >/=15 & MAP <50 ---iv DOPAMINE
        IF PCWP>/=15 & MAP >/=50
        Compelling Reason--INOTROPE
        NO Compelling reason--IV Vasodilator (arterial)
Subset IV
1. Congestion and Hypoperfusion
  1. Cold and Wet
    1. PCWP >18 & CI <2.2
      1. IV diuretics AND
        IF MAP <50--IV Dopamine
        if MAP >/=50
        NO compelling reason--IV Vasodilator
        Compelling Reason--Inotrope
    2. Pulmonary/Peripheral Congestion & Hypoperfusion
CI 2.2
PCWP 18

Forester Hemodynamic Subsets and Therapy

	Created by emette8 about 11 years ago