REFRACTORY HYPOTENSION-Diagnosis and Management in Surgical Patients

Refractory hypotension is circulatory collapse of obscure cause which occurs in surgical patients who are thought to have a normal blood volume but in whom adequate circulation cannot be maintained. Such patients are usually treated empirically by the administration of intravenous vasopressor agents, and the mortality rate is relatively high.A specific diagnosis of the underlying cause for the refractory hypotension can be made by thorough clinical evaluation. Specific treatment aimed at correcting the underlying cause of the vascular collapse will lower the mortality rate in this serious type of circulatory failure.