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Continuing the vasoactive meds week, we will talk about dopamine. It is a precursor of norepinephrine, inducing its release. There are dopamine receptors in the renal, splanchnic, coronary and cerebral vascular beds; stimulation of these receptors cause vasodilation. #critcare
Again, since our historical "nerdiness" was so well received, this is one of the first papers that talked about dopamin in shock:…
And this is their conclusion:"Because dopamine increases myocardial contractility, selectively redistributes perfusion to essential viscera and allows a pharmacologic titration of effect, it is a logical first-choice catecholamine for treatment of shock and refractory HF."
How far we've come, huh? Since then, Dopamine has been named the "silent killer" in shock.…
And in 2010, it was not shown to be a "killer", but it came with a multitude of side effects when used to treat various types of shock and compared to norepinephrine.…
To give dopamine some credit, it was found to be non-inferior to transcutaneous pacing in unstable bradycardia unresponsive to atropine.…
In conclusion, dopamine is a no go for shock, ok for unstable bradycardia unresponsive to atropine and good for the brain. 😉 #chestcritcare #critcare #pccm #shock
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