A 58 year old man is admitted to the Intensive Care Unit, intubated and ventilated. Haemodynamic monitors have been inserted and the following haemodynamic measurements have been recorded:
Mean arterial pressure 53 mmHg
Central venous pressure 15 mmHg
Cardiac output 6.8 L/min
[Cardiac index 3.8 L/min/m2]
1. Describe this circulatory disturbance.
The rest of the questions focused on the rational approach to uses of inotropes and vasopressor including a discussion of some of the recent evidence.
Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.