creating an updated/merged chapter on shock & vasoactives any good pearls or recent references on vasopressors & inotropes? also shoutout to @eddyjoemd.bsky.social, his handbook on vasopressors & inotropes is pretty great #EMIMCC - ThreadSky

pulmcrit.bsky.social • 38 days ago

creating an updated/merged chapter on shock & vasoactives

any good pearls or recent references on vasopressors & inotropes?

also shoutout to @eddyjoemd.bsky.social, his handbook on vasopressors & inotropes is pretty great #EMIMCC

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nicolaibangfoss.bsky.social•38 days ago

The target of vasoconstriction is primarily preload not BP

rmohty.bsky.social•38 days ago

Add this fun article https://pubmed.ncbi.nlm.nih.gov/19843802/

pulmcrit.bsky.social•38 days ago

neat!!!

damienbarraudmd.bsky.social•38 days ago

Maybe a chapter on NOREPI via peripheral catheters
And one about...landiolol/esmolol for septic shock ?

vataha.md•38 days ago

Also it seems via RSS you have added a lot of new content but it's not in TOC?

vataha.md•38 days ago

Can't wait

cjosephy.bsky.social•37 days ago

Probably a great opportunity to summarize the recent buzz about the role of nonadrenergic vasoconstrictors like MB and hydroxycobalamin and dare i say vitC Growing talk of earlier use in vasopressor refractory vasoplegia w ongoing RCTs. Interesting moving target/ topic in spite of not great evidence

babewiththe-power.bsky.social•37 days ago

Forgot who posted this, but a simple point made

cnemehmd.bsky.social•37 days ago

Something about the need for readily available/rapid renin assays and the effect that might have on us using angiotensin II more ubiquitously?

pulmcrit.bsky.social•37 days ago

I think the best way to determine pressor responsiveness is a pressor challenge.

If the patient has a huge response to low dose AngII, they're maybe deficient & it's more likely to be helping.

If the patient is refractory to AngII it's probably not helping, stop it.

Just try giving a small dose 🤷‍♂️

cnemehmd.bsky.social•37 days ago

Agreed. I think the cost prohibitive nature makes the empiric challenge a little more difficult on our end sometimes though. Was able to get it easily approved at some hospitals, more logistical hurdles at others.

cowscowscows.bsky.social•36 days ago

It's wild how these hospital differences happen, I've been a MICU RN for 6 years at a safety net hospital and I'd never heard of it, even when everyone's spitballing around a crashing 3 pressor pt.

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