Intensive Care Medicine (ICM) Practice Exam

In the context of cardiogenic shock, which medication might be used with caution?

1. Oxygen therapy

2. Diuretics

3. Vasopressors

4. Antipyretics

The correct answer is: Diuretics

In the management of cardiogenic shock, diuretics may indeed be used with caution, primarily due to their effects on intravascular volume and hemodynamics. In this condition, the heart's ability to pump effectively is compromised, leading to a decrease in cardiac output and potential organ hypoperfusion. Administering diuretics can lead to volume depletion, which may worsen the patient's hemodynamic status by further reducing preload and cardiac output. While diuretics are often necessary in managing fluid overload states, their use must be carefully balanced to avoid hypotension, especially in patients who are already hemodynamically unstable. Close monitoring is essential to ensure that the patient's fluid status is managed appropriately without sacrificing vital organ perfusion. In contrast, oxygen therapy is generally beneficial as it ensures adequate oxygen delivery to tissues, while vasopressors can help maintain blood pressure and improve perfusion in shock states. Antipyretics serve a different purpose, typically aimed at controlling fever rather than directly impacting hemodynamics. Understanding the nuances of these medications helps in providing optimal care for patients in cardiogenic shock.