Podcasts about vasopressors

A long-term analysis of major prediabetes trials found that achieving remission or returning glucose levels to normal was associated with over a 50% reduction in cardiovascular death or heart failure, with durable benefits decades later; delaying diabetes without remission did not show similar benefit. A randomized trial in critically ill adults found no difference in 28-day mortality between ketamine and etomidate for intubation, though ketamine increased the risk of cardiovascular collapse. Finally, molecular data showed indoor tanning causes widespread DNA mutations linked to melanoma, reinforcing its carcinogenic risk.

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn N. Bulloch, PharmD, BCPS, FCCM, speaks with Olfa Hamzaoui, MD, PhD, professor of intensive care at Robert Debré Hospital in Reims, France, about her Peter Safar Honorary Lecture at the 2025 Critical Care Congress. The conversation centers on tissue perfusion, microcirculation, and shock, with a focus on bridging the gap between bench research and bedside practice. Dr. Hamzaoui shares insights on current scientific understanding of microcirculation and shock, including research on tools to monitor microcirculation, such as handheld video microscopy. The discussion highlights the utility of capillary refill time as a simple, noninvasive tool for guiding resuscitation. Dr. Hamzaoui advocates for early and repeated echocardiographic assessment in shock management, including during de-resuscitation. She also discusses her 2023 article in Clinical Medicine, which proposed titrating norepinephrine to individualized targets. This episode offers a compelling look at how emerging tools and research can refine shock management and promote precision care in critical illness. This podcast is sponsored by Fresenius Kabi. Resources referenced in this episode:  Effects of a Resuscitation Strategy Targeting Peripheral Perfusion Status versus Serum Lactate Levels Among Patients with Septic Shock. A Bayesian Reanalysis of the ANDROMEDA-SHOCK Trial (Zampieri FG, et al. Am J Respir Crit Care Med. 2020;201:423-429) The Eight Unanswered and Answered Questions about the Use of Vasopressors in Septic Shock (Hamzaoui O, et al. J Clin Med. 2023;12:4589) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 (Evans L, et al. Crit Care Med. 2021;49:e1063-e1143)

A new prospective multicenter cohort of 250 patients with shock examines the safety and outcomes of peripheral vasopressor administration. Extravasation events were rare and clustered only after several days of infusion, while norepinephrine use and simple physiologic markers correlated with survival. In this episode, I translate the findings into bedside guardrails—which sites and gauges to use, how to monitor, and when to pivot to a central line.The Vasopressor & Inotrope HandbookAmazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation:Petros A, Melkie A, Kotiso KS, Kebede D, Oljira CF, Assefa Gemechu F, Yusuf H, Abebe S, Ashagre A, Bekele A, Yohannes A, Etesa EK, Bedru M, Gebremariam TH. Peripheral line for vasopressor administration: Prospective multicenter observational cohort study for survival and safety. PLoS One. 2025 Oct 13;20(10):e0333275. doi: 10.1371/journal.pone.0333275. PMID: 41082535; PMCID: PMC12517475.

In this episode, Dr. Sergio Zanotti discusses the administration of vasopressor agents through peripheral intravenous lines (or what we refer to as “peripheral vasopressors”). He is joined by Dr. Elizabeth Munroe, a practicing pulmonary/critical care physician and an Assistant Professor of Pulmonary and Critical Care at Intermountain Health in Salt Lake City, Utah. Her research interests include evidence-based resuscitation practices in early sepsis and septic shock, vasopressor administration practices, peripheral vasopressor use, and clinical trials, particularly novel, pragmatic clinical trial designs. Additional resources: Peripheral Vasopressor Use in Early Sepsis-Induced Hypotension. ES Munroe, et al. JAMA Network 2025: https://pubmed.ncbi.nlm.nih.gov/40864467/ Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Shapiro NI, et al. CLOVERS Trial. New Engl J of Med 2025: https://pubmed.ncbi.nlm.nih.gov/36688507/ Overview of Peripheral Vasopressor Use in an Academic Health System. D Shyu, et al. Ann Am Thorac Soc 2025: https://pubmed.ncbi.nlm.nih.gov/40126143/ Safety of peripheral intravenous administration of vasoactive medication. J Cardenas-Garcia, et al. J Hosp Med 2015: https://pubmed.ncbi.nlm.nih.gov/26014852/ Books mentioned in this episode: Ending Medical Reversal- Improving Outcomes, Saving Lives. By Vinayak K. Parsad, et al: https://bit.ly/4nhCNam

In part 3 of the Trauma and Burn Anesthesia series, we focus on blood product administration and fluid resuscitation, exploring how transfusions are tailored to support oxygen delivery, coagulation, and hemodynamic stability in critically injured patients. The episode examines the indications and composition of packed red blood cells, platelets, plasma, and cryoprecipitate, as well as the role of crystalloids and colloids in resuscitation. Key complications of transfusion—including transfusion related acute lung injury (TRALI) and transfusion associated circulatory overload (TACO)—are highlighted with emphasis on recognition, prevention, and management. Listeners are also guided through the principles of massive transfusion protocols (MTPs), including balanced product ratios, calcium supplementation, and rapid delivery systems that optimize outcomes in life-threatening hemorrhage.Want to learn more? Create a FREE account at www.atomicanesthesia.com⚛️ CONNECT:

In this episode, Sam Ashoo, MD interviews Lauren Black, MD about the August 2025 Emergency Medicine Practice article, Updates and Controversies in the Early Management of Sepsis and Septic Shock00:00 Introduction and Welcome01:09 Meet Dr. Lauren Page Black: Sepsis Expert01:56 Sepsis Statistics and Impact04:16 Understanding Sepsis Definitions09:56 Screening Tools for Sepsis13:57 Pre-Hospital Sepsis Recognition19:33 Clinical Examination and Diagnostics24:03 The Role of Lactate and Procalcitonin27:40 Clinical Gestalt and Imaging in Diagnosis29:21 CMS Bundle Requirements and Updates34:02 Fluid Type Preferences in Sepsis36:49 Antibiotic Timing and Selection43:43 Vasopressors and Steroids in Sepsis Management50:18 Special Populations and Future Directions53:44 Conclusion and ResourcesEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net 

Show notes at pharmacyjoe.com/episode1006. In this episode, I'll discuss a review article on the safety of peripheral vasopressors and hypertonic saline. The post 1006: Any Port in a Storm (For a Little While At Least) – The Safety of Peripheral Vasopressors and Hypertonic Saline appeared first on Pharmacy Joe.

The early initiation of vasopressors, ideally within the first hour of diagnosing septic shock, is emerging as a preferred strategy. This approach offers a multimodal action with potential benefits, including reduced morbidity and mortality. Prompt vasopressor therapy is crucial for effective management in septic shock patients. To dive deeper into the timing and administration of vasopressors, join us for our next podcast! Michele Chew and Mathieu Jozwiak will guide us through the essentials—don't miss it!

In this episode of the PFC Podcast, Dennis and JP Kolcun, a neurosurgery resident, delve into the complexities of spinal trauma. They discuss the differences between spinal shock and neurogenic shock, the assessment and management of penetrating and blunt spinal injuries, and the critical importance of addressing secondary injuries. The conversation emphasizes the need for timely intervention and the nuances of trauma care in both field and hospital settings. This conversation delves into the complexities of spinal cord injury treatment, emphasizing the importance of timely surgical decompression, understanding spinal cord perfusion, and the role of intrathecal pressure. The discussion highlights the need for optimizing spinal cord perfusion pressure and the implications of using vasopressors. Innovations in treatment, including the potential for intrathecal medication delivery and advancements in brain-computer interfaces, are explored as future avenues for improving patient outcomes. Takeaways Spinal shock is a neurologic phenomenon, while neurogenic shock is hemodynamic. Penetrating spinal cord injuries are often more severe than blunt injuries. Immediate stabilization and ABCs are crucial in trauma care. Understanding the difference between spinal shock and spinal cord injury is vital. Secondary injury can worsen outcomes if not addressed promptly. Timely decompression of the spinal cord can improve recovery chances. Assessment of spinal stability is essential in blunt trauma cases. The presence of a bulbocavernous reflex can indicate spinal cord injury. Norepinephrine is preferred for treating neurogenic shock. Avoid hypotension to prevent further complications in spinal injuries. The timing of surgical decompression can significantly impact recovery. Surgical decisions must consider the overall health of the patient, not just the injury. Spinal cord perfusion is critical for recovery post-injury. Intrathecal pressure varies and can affect spinal cord perfusion. Targeting spinal cord perfusion pressure may improve outcomes over traditional MAP goals. Vasopressors can constrict blood vessels, potentially reducing perfusion to the spinal cord. Innovative treatments, such as lumbar drains, can enhance spinal cord perfusion. Research is ongoing into the use of intrathecal medications for spinal cord injury. The ultimate goal is to improve quality of life for spinal cord injury patients. Advancements in technology may lead to breakthroughs in treating chronic spinal cord injuries. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In this REBOOTED episodes of Critical Care Time, Cyrus and Nick explore the basic in's and out's of vasopressors, providing a framework for understanding them and recommendations for the who, what, when, where and why as it pertains to their use! If you are new to the ICU or work anywhere that vasopressors may be used to treat your patients, this is the episode for you! Hosted on Acast. See acast.com/privacy for more information.

In this REBOOTED episodes of Critical Care Time, Cyrus and Nick go beyond the basics of vasopressor management. This thing is jam-packed with high-yield pearls, where we discuss important topics such as how to titrate vasopressors, what can be done when vasopressors seem to be failing and how to wean patients from vasopressors in order to successfully get them out of the ICU and ultimately home. Sit back, relax, and enjoy this hour long master-class on Vasopressors - Beyond the Basics! Hosted on Acast. See acast.com/privacy for more information.

Each month, EMedHome.com presents EMCast, the 90-minute podcast hosted by Dr. Amal Mattu, the premier educator in Emergency Medicine.  Subscribe to EMedHome.com for an array of clinical content that will impact every shift.  This month's EMCast covers:(1) Alcohol Withdrawal, Cannabinoid Hyperemesis Syndrome(2) Vasopressors in the ED(3) Non-Invasive Ventilation in the ED

Podcast summary of articles from the July 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include pancreatitis risk scores,  pediatric asthma, critical care education, carotidynia, and a review of vasopressors.  Guest speaker is Dr. Kinda Sweidan.

Today's episode is the final in our series on inotropic and vasopressor medications. Today, we're going to tackle some of the more obscure inotropes and vasopressors - these medications typically aren't encountered terribly often within anaesthesia. During this episode, we discuss milrinone, levosimendan, methylene blue and hydroxocobalamin (Vitamin B12).  Resources for today's episode:StatPearls:Inotropes and vasopressors by D. VanValkinburgh et al.Adrenergic Drugs by K. Farzam et al.LITFL:Inotropes, vasopressors and other vasoactive agents by C. NicksonMilrinone by C. NicksonLevosimendan by C. NicksonMethylene blue by C. NicksonHydroxocobalamin by N. LongDeranged Physiology:Classification of inotropes and vasopressorsMilrinoneLevosimendanDRUGBANK Online:MilrinoneLevosimendanFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

Today's episode - the second in our three episode series focusing on inotropic and vasopressor medications - sees us covering some more medications commonly (or uncommonly, depending on your scope of practice) encountered within anaesthesia. During this episode, we discuss vasopressin, dopamine and dobutamine.  Resources for today's episode:StatPearls:Inotropes and vasopressors by D. VanValkinburgh et al.Adrenergic Drugs by K. Farzam et al.LITFL:Inotropes, vasopressors and other vasoactive agents by C. NicksonVasopressin by C. NicksonDopamine by C. NicksonDobutamine by C. NicksonDeranged Physiology:Classification of inotropes and vasopressorsVasopressinDobutamineDRUGBANK Online:VasopressinDopamineDobutamineBJAED:Vasopressin and its role in critical care by A. Sharman & J. Low.Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast crisis in the ED, and Leah Flanagan & Liam Loughrey on the rise of nitrous oxide toxicity...

Today's episode is the first in a series of three that focus on inotropic and vasopressor medications used within anaesthetic practice. During this episode, we discuss metaraminol, ephedrine, phenylephrine, noradrenaline and adrenaline.  There's one section of our episode where we thought it important to clarify what we're saying, as to out ears it sounds a little confusing. During our discussion about adrenaline, we state that both noradrenaline and adrenaline have the same affinity for beta-1 adrenoceptors. We then advise that the reason for the inotropic and chronotropic effects of adrenaline - not seen with noradrenaline - are because adrenaline has much greater affinity for beta-2 adrenaceptors than noradrenaline.Resources for today's episode:StatPearls:Inotropes and vasopressors by D. VanValkinburgh et al.Adrenergic Drugs by K. Farzam et al.LITFL:Inotropes, vasopressors and other vasoactive agents by C. NicksonMetaraminol by R. ButtnerPhenylephrine by C. NicksonNoradrenaline by C. NicksonAdrenaline by C. NicksonDeranged Physiology:Classification of inotropes and vasopressorsMetaraminolNoradrenalineAdrenalineDRUGBANK Online:MetaraminolEphedrinePhenylephrineNoradrenalineAdrenalineFeel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

This is the third and final episode of the series focused on basic anesthetic drugs. In this episode, we will explore vasopressors and inotropes.  After listening to this episode, you will be able to: 1. Outline the role of vasopressors 2. List the 5 main vasopressors used in the OR and their indications 3. Describe the mechanism of action for Phenylephrine, Ephedrine, Norepinephrine, Epinephrine, and Vasopressin  

PDF Notes for Surgery 101 episode on Basic Anesthetic Drugs: Vasopressors and Inotropes

Contributor: Travis Barlock MD Educational Pearls: Recent study assessed outcomes after ROSC with epinephrine vs. norepinephrine Observational multicenter study from 2011-2018 285 patients received epineprhine and 481 received norepinephrine Epinephrine was associated with an increase in all-cause mortality (primary outcome) Odds ratio 2.6; 95%CI 1.4-4.7; P = 0.002 Higher cardiovascular mortality (secondary outcome) Higher proportion of unfavorable neurological outcome (secondary outcome) Norepinephrine is the vasopressor of choice in post-cardiac arrest care References Bougouin W, Slimani K, Renaudier M, et al. Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022;48(3):300-310. doi:10.1007/s00134-021-06608-7 Summarized by Jorge Chalit, OMSIII | Edited by Meg Joyce & Jorge Chalit  

In this episode, Rhea and Sachi discuss the most common vasopressors used in the OR, their indications, dose and mechanism of action. [FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.com

CHEST April 2024, Volume 165, Issue 4 Elizabeth S. Munroe, MD, joins CHEST Podcast Moderator Dominique Pepper, MD, to discuss the use of vasopressors in routine practice and potential associations between vasopressor initiation route and in-hospital mortality. DOI: https://doi.org/10.1016/j.chest.2023.10.027   Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine.

Moderator: BobbieJean Sweitzer, M.D. Participants: Maximilian Sebastian Schaefer, M.D. and Amy Gaskell, M.B.Ch.B., Ph.D. Articles Discussed: Intraoperative Use of Phenylephrine versus Ephedrine and Postoperative Delirium: A Multicenter Retrospective Cohort Study Caveat Emptor: Vasopressor Choice and Postoperative Delirium—A Complex Relationship Explored Transcript

Cardiac output equals heart rate times stroke volume… but what does that really mean and how does it apply to the bedside? This formula (CO = HR x SV) is crucial for nurses to understand in the application of vasopressors and inotropes, so why is it so difficult to memorize their role in improving cardiac output?This episode is dedicated to breaking down these life-saving medications so you can not only memorize their expected effect on vital signs, but more importantly, understand how they work in the body. Host Sarah Lorenzini provides a comprehensive lesson in these three classes of medications: vasopressors, inopressors and inodilators. She covers how each affects heart rate and stroke volume, diving into the alpha and beta adrenergic receptors that impact cardiac output.Sarah also shares memory aids to help you remember these concepts and apply them to your clinical decision making.Tune in now to learn the basics of vasopressors and inotropes!Topics discussed in this episode:The role of sympathomimetics to improve cardiac outputAdrenergic and vasopressin receptorsVasopressor types and medicationsMentioned in this episode:AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!Rapid Response and Rescue Intro CourseCONNECT

On this episode, we continue our examination of cardiac surgery with its unique challenges and risks for patients, with a  focus on accurate and thorough documentation of these procedures.   Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient Guest: Rachel Mack, MSN, RN, CCDS, CDIP,  CCS, CRC Consulting Director Clinical Documentation Improvement Vizient   Show Notes: [00:31] Cardiac surgery patients: post-op and readmissions [01:24] “Volume overload,” i.e., heart failure [01:47] Five-day readmission stays! [03:34] Story – cardiac patient on the move [04:49] Common cardiac surgeries [08:22] Vasopressors do not always indicate shock [09:24] Encephalopathy and dementia   Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Rachel's email: rachel.mack@vizientinc.com   Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

Podcast summary of articles from the September 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include EMS cardiac rhythms, vasopressors, naloxone, hyperglycemia, DKA protocols, and spider bites.  Guest speaker is Dr. James O'Hora.

Today we have one tip for shocky patients on the floor supplemented by some info from the Management of the Hospitalized Patient 2023 (more coming in the future!), and a bunch of tips including TIPS for managing upper GI bleeds, Ascites, SBP, and HRS. | 00.00 Opening & TOC | | 01.02 Consider vasopressors via PIV - JHM 2022, Surviving Sepsis 2021 | | 04.15 Upper GI bleeding - ACG 2021 | | 05.26 Ascites, SBP - AASLD 2021 | | 07.32 Hepatorenal Syndrome | | 08.04 Closing | [The appearance of external hyperlinks does not constitute endorsements by UCSF of the linked websites, or the information, products, or services contained therein. UCSF does not exercise any editorial control over the information found therein, nor does UCSF make any representation of their accuracy or completeness. All information contained in this episode are the opinions of the respective speakers and not necessarily the views their respective institutions or UCSF, and is only provided for information purposes, not to diagnose or treat.] Additional Credits: Contents by the Clinical Knowledge Communicty Dispatch. Music by Amit Apte. Drip Vectors by Vecteezy

On this episode of Critical Care Time, Cyrus and Nick go beyond the basics of vasopressor management. This thing is jam-packed with high-yield pearls, where we discuss important topics such as how to titrate vasopressors, what can be done when vasopressors seem to be failing and how to wean patients from vasopressors in order to successfully get them out of the ICU and ultimately home. Sit back, relax, and enjoy this hour long master-class on Vasopressors - Beyond the Basics! Hosted on Acast. See acast.com/privacy for more information.

We go over the essential and complex topic of vasopressors in the ED. Hosts: Brian Gilberti, MD Catherine Jamin, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Vasopressors.mp3 Download Leave a Comment Tags: Critical Care Show Notes Introduction Host: Brian Gilberti, MD Guest: Catherine Jamin, MD Associate professor of Emergency Medicine at NYU Langone Health Vice Chair of Operations Triple-boarded in Emergency Medicine, Internal Medicine, and Critical Care Medicine Topic: Vasopressors: Essential agents for supporting critically ill patients in the ED What Are Vasopressors and When to Use Them Two primary mechanisms to increase blood pressure: Increasing systemic vascular resistance via vasoconstriction Increasing cardiac output via augmenting inotropy and chronotropy Indicators for vasopressor use: MAP

On this episode of Critical Care Time, Cyrus and Nick explore the basic in's and out's of vasopressors, providing a framework for understanding them and recommendations for the who, what, when, where and why as it pertains to their use! If you are new to the ICU or work anywhere that vasopressors may be used to treat your patients, this is the episode for you! Whether you are ordering them, titrating them or looking out for complications associated with their use, Nick & Cyrus have got your back! Hosted on Acast. See acast.com/privacy for more information.

Contributor: Travis Barlock MD Educational Pearls: Three categories of pressors: inopressors, pure vasoconstrictors, and inodilators Inopressors:  Epinephrine - nonselective beta- and alpha-adrenergic agonism, leading to increased cardiac contractility, chronotropy (increased heart rate), and peripheral vasoconstriction. Dose 0.1mcg/kg/min. Levophed (norepinephrine) - more vasoconstriction peripherally than inotropy; useful in most cases of shock. Dose 0.1mcg/kg/min. Peripheral vasoconstrictors: Phenylephrine - pure alpha agonist; useful in atrial fibrillation because it avoids cardiac beta receptor activation and also in post-intubation hypotension to counteract the RSI medications. Start at 1mcg/kg/min and increase as needed. Vasopressin - No effect on cardiac contractility. Fixed dose of 0.4 units/min. Inodilators are useful in cardiogenic shock but often not started in the ED since patients mostly have undifferentiated shock Dobutamine - start at 2.5mcg/kg/min. Milrinone - 0.125mcg/kg/min. References 1. Ellender TJ, Skinner JC. The Use of Vasopressors and Inotropes in the Emergency Medical Treatment of Shock. Emerg Med Clin North Am. 2008;26(3):759-786. doi:https://doi.org/10.1016/j.emc.2008.04.001 2. Hollenberg SM. Vasoactive drugs in circulatory shock. Am J Respir Crit Care Med. 2011;183(7):847-855. doi:10.1164/rccm.201006-0972CI 3. Lampard JG, Lang E. Vasopressors for hypotensive shock. Ann Emerg Med. 2013;61(3):351-352. doi:10.1016/j.annemergmed.2012.08.028 Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII  

CardioNerds (Daniel Ambinder) join Dr. Tomio Tran, Dr. Vid Yogeswaran, and Dr. Amanda Cai from the University of Washington for a break from the rain at the waterfront near Pike Place Market. They discuss the following case: A 46-year-old woman presents with cardiac arrest and was found to have cor triatriatum sinistrum (CTS). CTS is a rare congenital cardiac malformation in which the left atrium is divided by a fenestrated membrane, which can restrict blood flow and cause symptoms of congestive heart failure. Rarely, the condition can present in adulthood. To date, there have been no cases of sudden cardiac death attributed to CTS. Dr. Jill Steiner provides the E-CPR for this episode. Audio editing by CardioNerds Academy Intern, student doctor Akiva Rosenzveig. CardioNerds is collaborating with Radcliffe Cardiology and US Cardiology Review journal (USC) for a ‘call for cases', with the intention to co-publish high impact cardiovascular case reports, subject to double-blind peer review. Case Reports that are accepted in USC journal and published as the version of record (VOR), will also be indexed in Scopus and the Directory of Open Access Journals (DOAJ). CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - A Sinister Cause of Sudden Cardiac Death – University of Washington A 40-year-old woman with a history of recurrent exertional syncope had sudden loss of consciousness while kissing her partner. The patient received bystander CPR while 911 was called. EMS arrived within 10 minutes of the call and found the patient apneic and unresponsive. Initial rhythm check showed narrow complex tachycardia at a rate of 136 BPM. ROSC was eventually achieved. A 12-lead ECG showed that the patient was in atrial fibrillation with rapid ventricular rate. The patient was intubated and brought to the emergency department. The patient spontaneously converted to sinus rhythm en route to the hospital. In the emergency department, vital signs were remarkable for hypotension (76/64 mmHg) and sinus tachycardia (110 BPM). The physical exam was remarkable for an inability to follow commands. Laboratory data was remarkable for hypokalemia (2.5 mmol/L), transaminitis (AST 138 units/L, ALT 98 units/L), acidemia (pH 7.12), and hyperlactatemia (11.2 mmol/L). CT scan of the chest revealed a thin membrane within the left atrium. Transthoracic echocardiogram showed normal biventricular size and function, severe tricuspid regurgitation, pulmonary artery systolic pressure of 93 mmHg, and the presence of a membrane within the left atrium with a mean gradient of 25 mmHg between the proximal and distal left atrial chambers. Vasopressors and targeted temperature management were initiated. The patient was able to be re-warmed with eventual discontinuation of vasopressors, however she had ongoing encephalopathy and seizures concerning for hypoxic brain injury. There was discussion with the adult congenital heart disease team about next steps in management, however the patient was too sick to undergo any definitive treatment for the intracardiac membrane within the left atrium. The patient developed ventilator associated pneumonia and antibiotics were initiated. The patient ultimately developed  bradycardia and pulseless electrical activity; ROSC was unable to be achieved, resulting in death. Autopsy was remarkable for the presence of a fenestrated intracardiac membrane within the left atrium and lack of other apparent congenital heart defects. There was right ventricular hypertrophy and pulmonary artery intimal thickening with interstitial fibrosis suggestive of pulmonary hypertension. There were bilateral acute subsegmental pulmonary emboli present. The cause of death was declared to be arrhythmia in the setting of pulmonary hypertension and right s...

Show notes at pharmacyjoe.com/episode806. In this episode, I'll discuss a review article on the safety of peripheral vasopressors and hypertonic saline. The post 806: Updating Beliefs On the Safety of Peripheral Vasopressors and Hypertonic Saline appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode806. In this episode, I ll discuss a review article on the safety of peripheral vasopressors and hypertonic saline. The post 806: Updating Beliefs On the Safety of Peripheral Vasopressors and Hypertonic Saline appeared first on Pharmacy Joe.

It's not uncommon to use push-dose vasopressors for blood pressure management in anesthesia practice. Maybe even more so now than in the past. Jeremy and Sass talk about the various options and situations for blousing vasopressors, and perhaps most importantly which one to use. In fact, recently there was a Journal Course in the AANA Journal talking about the increased (and safe) use of push dose Norepinephrine which they review in this episode. Here are some of the things you'll learn on this show: Why we're administering push-dose vasopressors more often now. (2:18) Different vasopressors that we use. (7:09) Here's our scenario for treatment for this episode. (10:45) What the research tells us. (13:03) Comparing phenylephrine to ephedrine. (18:03) How effective norepinephrine is and what are the concerns? (19:26) The best method for administering norepinephrine. (21:27)   About our hosts: https://kpatprogram.org/about-the-school/faculty.html  Visit us online: http://beyondthemaskpodcast.com  Get the CE certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf

We're back with Season 4! Sorry for the unplanned hiatus. Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PREVENT CLOT study, which compared aspirin to enoxaparin for VTE prophylaxis after a traumatic fracture, and the AID-ICU study, which compared haloperidol to placebo in the treatment of ICU delirium. CLOVERS trialTorsemide vs Furosemide in CHFAspirin vs Enoxaparin for VTE ppx after FractureIV Haloperidol in ICU DeliriumWe also quickly review some papers we missed in 2022:Apixaban for VTE in ESRD Acetazolamide for Congestive Heart FailureModerate or Aggressive IV Fluids for PancreatitisPerioperative Management of AnticoagulationCRISTAL study (aspirin vs enoxaparin after TKA/THA)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Show Notes: Coming Soon! TrueLearn Link: https://truelearn.referralrock.com/l/EDDYJOEMD25/Discount code: EDDYJOEMD25 Citation: National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; Shapiro NI, Douglas IS, Brower RG, Brown SM, Exline MC, Ginde AA, Gong MN, Grissom CK, Hayden D, Hough CL, Huang W, Iwashyna TJ, Jones AE, Khan A, Lai P, Liu KD, Miller CD, Oldmixon K, Park PK, Rice TW, Ringwood N, Semler MW, Steingrub JS, Talmor D, Thompson BT, Yealy DM, Self WH. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. N Engl J Med. 2023 Jan 21. doi: 10.1056/NEJMoa2212663. Epub ahead of print. PMID: 36688507. --- Support this podcast: https://anchor.fm/eddyjoemd/support

Kyle A. Hess, PharmD (@KyleHessPHarmD) describes the rationale for early use of vasopressors with multiple mechanisms of action in patients with septic shock, reviews the literature examining the early initiation of vasopressin in patients with septic shock and identifies patient characteristics associated with positive response to angiotensin II. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

We talk about vasopressors, how they work and the most common mistakes we see when using these drugs.

We are FINALLY publishing the third part of our series on hypotension management. Please welcome Dr. Kelley Varner to the podcast - our new cohost! In this episode, we review the basic concepts of cardiac output and steps #1-4 of our method, the main receptors of the sympathetic nervous system, and the pressors and inotropes we use to increase blood pressure. 

Contributor: Aaron Lessen, MD Educational Pearls: There are two common options for push-dose vasopressor: phenylephrine and epinephrine. Both have been studied in the setting of the OR, but are lacking data in emergency room utilization.  A recent retrospective study at one hospital compared the two options for effectiveness and safety. The data showed phenylephrine raised systolic pressure an average 26 points while epinephrine raised the systolic pressure higher, an average of 33 points. Additionally, the same study showed dosing errors were more common in epinephrine. The error rates were 13% and 2% when using premixed syringes of epinephrine and phenylephrine respectively. However, overall no increase in adverse outcomes were reported between the two drugs in this study.  References Nam E, Fitter S, Moussavi K. Comparison of push-dose phenylephrine and epinephrine in the emergency department. Am J Emerg Med. 2022;52:43-49. doi:10.1016/j.ajem.2021.11.033 Weingart S. Push-dose pressors for immediate blood pressure control. Clin Exp Emerg Med. 2015;2(2):131-132. Published 2015 Jun 30. doi:10.15441/ceem.15.010   Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD   The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.  Donate to EMM today!

GuestDiana LemieuxSenior Clinical Pharmacy SpecialistYale New Haven HospitalHostMarilyn N. Bulloch, PharmD, BCPS, FCCMAssociate Clinical Professor and Director of Strategic OperationsHarrison College of Pharmacy | Auburn University

GuestsDr. Gretchen Sacha, PharmD, BCCCPCleveland ClinicDr. Patrick M. Wieruszewski, PharmD, BCCCPMayo ClinicHostDr. Carolyn M. Bell, PharmD, BCCCPMedical University of South Carolina

This week, Rob and Zach will be teaching you everything you need to know about Vasopressors!We will be discussing the mechanism of action, indications, titration parameters, pros/cons, and routes of administration during this episode on Vasopressors! The categories of Vasopressors we will be discussing will include:InodilatorsInopressorsPure VasopressorsOther VasopressorsOral VasopressorTo follow along with Notes & Illustrations for our podcasts please become a member on our website! https://www.ninjanerd.org/podcast/vasopressorsFollow us on:YouTube: https://www.youtube.com/ninjanerdscienceInstagram: https://www.instagram.com/ninjanerdlecturesFacebook: https://www.facebook.com/NinjaNerdLecturesTwitter: https://twitter.com/ninjanerdsciDiscord: https://discord.com/invite/3srTG4dngWTikTok: https://www.tiktok.com/@ninjanerdlecturesSupport the show

Dr. Haney Mallemat, a triple-boarded critical care physician and Editor-in-Chief at criticalcarenow.com, joins us to discuss all things vasopressor related. During the interview, Dr. Mallemat mentions the Arginine Vasopressin During the Early Resuscitation of Traumatic Shock (AVERTShock) trial. You can find a summary of that study here, and deployedmedicine.com has a good video discussing the trial as well.Dr. Mallemat also mentions a study describing a "central line-less" ICU while discussing the safety of vasopressin administration through peripheral IVs. You can find that study here:Cardenas-Garcia, J., Schaub, K. F., Belchikov, Y. G., Narasimhan, M., Koenig, S. J., & Mayo, P. H. (2015). Safety of peripheral intravenous administration of vasoactive medication. Journal of hospital medicine, 10(9), 581–585. https://doi.org/10.1002/jhm.2394

A practical approach to choosing and escalating vasopressors for patients in shock.

Tina Vinsant, RN, host of the podcast Good Nurse Bad Nurse, joins us for a run through of all the major vasoactive agents given in the hospital. We minimized the jargon and maximized on practical cases, so join us for a memorable discussion of this fundamental subject.Check out Nicole Kupchik's exam reviews and practice questions at nicolekupchikconsulting.com. Use the promo code UPMYGAME20 to get 20% off all products.Use the promo code UMNG10 to get 10% off your order from Stoggles.Up My Nursing Game is partnering with VCU Health Continuing Education to offer FREE continuing education credits for registered nurses. Click here to obtain nursing credit (1.00).See the show notes at upmynursinggame.com.

This episode discussed two major concepts, the optimal blood pressure target for trauma patients and the use of vasopressors in trauma (WHAT!).  We look at the use of permissive hypotension in trauma and discuss its applications and indications as well as its history.  This of course is merely a prelude to our discussion of the use of pressors in trauma, which many of us know is true sacrilege... or is it?  We examine the question through the lens of the AVERT-SHOCK trial and discuss this in-depth.