Action
Start dobutamine infusion at 2-10 mcg/kg/min (Class II)
Decision
Worsening markers of perfusion or rapidly increasing vasopressors and /or inotropes?
Yes
Consider mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (VA ECMO) or peripheral ventricular assist device (VAD) (Class II)
No
Admit or transfer to a specialized cardiac ICU (Class I)
