important thread 👇
{norepi + vaso} can often induce a state of *normotensive* vasoconstrictive shock
this is why I dislike blind algorithms that start with NE, then pile on vaso on without considering global hemodynamics
for experts, there is no such thing as a “1st/2nd/3rd line” pressor #EMIMCC
{norepi + vaso} can often induce a state of *normotensive* vasoconstrictive shock
this is why I dislike blind algorithms that start with NE, then pile on vaso on without considering global hemodynamics
for experts, there is no such thing as a “1st/2nd/3rd line” pressor #EMIMCC
Reposted from
Lars Mølgaard Saxhaug
If the LV of the patient with sepsis is «hyperdynamic» when on noradrenaline, then EF dropps and the LV looks poorly when vasopressin is added, but recovers to normal with dobutamine, you likely haven’t «uncovered hidden LV dysfunction» or septic cardiomyopathy. #emimcc #pocus #echofirst 1/
Comments
I tend to use more a noradre threshold 0,1 mcg/kg/min / 10-15 mcg/min as 1st thinking point
@load-dependent.bsky.social are you using method of Chen?
I don’t routinely but will often have a PAC in with these patients
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