In a post CABG patient with hypotension, low CO/CI, high PWP, and high SVR, which intervention is indicated?

In a post-CABG patient exhibiting hypotension, low cardiac output (CO) and cardiac index (CI), elevated pulmonary wedge pressure (PWP), and high systemic vascular resistance (SVR), the most appropriate intervention is the use of an inotrope.

Inotrope administration is indicated in cases where the heart's ability to pump effectively is compromised. This patient's low CO and CI suggest that the heart is not generating adequate output, which can lead to inadequate tissue perfusion and further complicate the recovery process post-surgery. The elevated PWP indicates increased left atrial pressure, often due to fluid congestion, which can be a result of heart failure or low cardiac output.

While volume resuscitation could potentially help, it is not appropriate here considering the high PWP, which suggests the patient's heart is struggling to manage the existing volume status. In addition, while vasopressors are useful for increasing blood pressure, they do not directly improve the heart's contractility or address the underlying issue of low output. Vasodilators would further lower blood pressure, which is undesirable in this scenario, particularly since the patient is already experiencing hypotension.

Thus, the infusion of an inotropic agent is favored to enhance myocardial contractility and improve cardiac