Vasoactive-Inotropic Score (VIS)
Composite measure of inotropic / vasoactive drug support (Gaies 2010). VIS = dopamine + dobutamine + 100×(epi + norepi) + 10×milrinone + 10000×vasopressin + 100×isoproterenol (all µg/kg/min, vasopressin in U/kg/min). High VIS in first 48 h post-cardiac surgery predicts mortality and morbidity.
Score interpretation
→ Routine post-op ICU care. Wean inotropes as haemodynamics permit.
→ Echocardiography to assess ventricular function; optimise preload, afterload, rhythm, calcium. Consider lactate trend and SvO₂.
→ Senior ICU/cardiac review. Mechanical support (IABP, Impella, V-A ECMO) consideration; aggressive correction of metabolic derangement; surgical re-look if ongoing low cardiac output.
→ ECMO / VAD pathway activation. Transplant centre liaison if appropriate. Family counselling on prognosis.
Interpretation bands for the VIS. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Melatonin · Melatonin Receptor Agonist
- Enteral feeds · Nutritional support
- Rapid Sequence Induction (RSI) · DAS 2015 / AAGBI
- ICU Sedation and Analgesia · SCCM / NICE CG83
- Vasopressor Escalation in Shock · Surviving Sepsis Campaign 2021
- Tracheostomy Management · NTSP / ICS guidelines
- Otitis Media with Effusion (Glue Ear) · NICE NG176 (2021)
- Febrile Child Assessment (Traffic Light) · NICE CG160 2013
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.