Discover and read the best of Twitter Threads about #Vasopressors

Most recents (4)

“Ten tips to optimize #vasopressors use in the critically ill patient with #hypotension.” #IntensiveCare #MedTwitter #CardioTwitter #sepsis #FOAMed #FOAMcc #CriticalCare #EmergencyMedicine #PedsICU #ICU #EMCCM
📚 Intensive Care Med (2022) 48:736–739 rdcu.be/c57Se
1. Set goals of mean or diastolic blood pressures.
2. Individualize the arterial pressure targets goals.
3. Vasopressors induce an endogenous fluid recruitment and may limit positive fluid balance.
4. Reassess fluid status and cardiac output after initiation of vasopressors
5. Consider agents with a different mechanism of action as a second line agent.
6. Consider adding hydrocortisone in patients on high doses of vasopressors.
7. Vasopressin is an option in patients with right ventricular failure.
8. There is no maximal dose of vasopressors.
Read 4 tweets
What is your take on #vasodilators in acute #HeartFailure? The upcoming November issue of #EHJACVC will bring you a PRO/CON "Vasodilator therapy in acute heart failure revisited"

As our PRO paper was published in advanced access, a sneak preview Tweetorial below...

@EHJACVCEiC
First some background...
Current @escardio guidelines state (IIb, B): "In patients with AHF and a systolic blood pressure (SBP) >110 mmHg, intravenous vasodilators may be considered as an initial therapy to improve symptoms and reduce congestion."
Only 1 flowchart has them in...
So far, I consider this a fair recommendation... In hyper/normotensive pulmonary oedema, they might be helpful in some cases, with their main benefit a reduced need for (non-)invasive ventilation!

Beautiful (older) trial by Gad Cotter on this: thelancet.com/journals/lance…
Read 14 tweets
It was a privilege to share the (virtual) stage with an amazing panel discussion of differences between PICU and MICU care by #POPCoRNet. Thanks to @DrPhilipVerhoef @DeannaMarie208 @davidshoremd @DoctorVig @MihirAtreya @ArunK_MD @PfarrMarie @annaberry29 for arranging. #FOAMcc 1/3
We covered some important adult and pediatric ICU topics including #Pain/#Anxiety/#Delirium (PAD) treatment, #COVIDairway management, #ARDS #ventilator strategy, #proning, #vasopressors, & how to perform #ACLS while wearing PPE. I've attached some relevant OnePagers. 2/3 ImageImageImage
Very thankful to the amazing international audience who contributed great comments and discussion. Bottom line: adults are just big kids and there are some great pediatric intensivists out there who are ready care for adults with #COVID thanks to #POPCoRNetwork resources. 3/3
Read 4 tweets
This week's Tweetorial is by @doctorsinfuga & is on the #CENSER study published by @ATSBlueEditor last week showing early noradrenaline is associated with increased shock control by 6 hours:
atsjournals.org/doi/pdf/10.116…
#atsjournals #sepsis #vasopressors
CENSER was a phase II, randomized, double-blind, placebo-controlled clinical single center trial conducted in Bangkok during the October 2013 to March 2017
Adults aged ≥18 years who presented to the emergency room with MAP<65mmHg and suspected infection were eligible for inclusion
Read 18 tweets

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