A 13-year-old with systemic lupus erythematosus has hypotension, CVP of 15 mm Hg, cool extremities,...

These signs suggestmyocardial dysfunctionwith volume overload (elevated CVP and lung congestion). Further fluid wouldworsenthe condition.Inotropic support(e.g., milrinone,dobutamine) is appropriate to improvecontractility and cardiac output.

“In SLE-related myocarditis or cardiac involvement, inotropes are indicated when volume overload is present with poor perfusion.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Myocarditis and Inotropic Therapy)