aortic pulsatility index

Aortic Pulsatility Index (API): Optimizing Cardiogenic Shock Management

Welcome to the blog post version of the Saving Lives Podcast. In this post, I'm going to be discussing the aortic pulsatility index. Chances are you've never heard of this before. The reality is that I honestly had never heard of this before either. I ran into it been going down my rabbit hole of …

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cardiogenic shock classification

Cardiogenic Shock: SCAI Stage Classification

With a close to 50% mortality rate for cardiogenic shock, we all need a do a better job of caring for these patients. A cardiogenic shock classification would help identify who needs the most help.This is created for anyone caring for cardiogenic shock including physicians, APPs and nurses.We are all in this together. The earlier …

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cardiogenic shock norepinephrine epinephrine

Norepinephrine or Epinephrine in Cardiogenic Shock: Is One Better?

Which should be the first-line vasopressor between norepinephrine and epinephrine in cardiogenic shock?Your patient had an MI and is now in cardiogenic shock.They are hypotensive and need a vasopressor.To clarify, The Crit Doc of Tik Tok aka CriticalCareNow aka Haney Mallemat likes epinephrine as an inotrope, not a vasopressor.This was a pilot study, meaning that …

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cardiogenic shock swan

Cardiogenic Shock & Swan-Ganz/Pulmonary Artery Catheters

Mortality for patients in cardiogenic shock is finally improving to be less than 50%. It had been hovering at 50% for decades. Would floating a Swan Ganz catheter, also known as a Pulmonary Artery Catheter improve outcomes in Cardiogenic Shock? The ESCAPE trial took the winds out of the sails of the Swan-Ganz enthusiasts in …

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pulmonary artery pulsatility index

Pulmonary Artery Pulsatility Index (PAPi): Principles & Calculation

To not fly blind in patients with advanced heart failure or cardiogenic shock, certain equations exist to help us manage our patients. This helps us identify who is not doing well and act on their deterioration before it really hits the fan. We use cardiac power output (CPO), which I have dissected in THIS POST, …

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milrinone dobutamine

Milrinone or Dobutamine in Cardiogenic Shock?

Is your institution a milrinone shop or a dobutamine shop? Or do you have a mixed shop?It seems that most institutions are accustomed to use mostly one or the other in cardiogenic shock.Some argue that milrinone is better.Some argue that dobutamine is better.But do we know the answer?This was answered late in 2021 in the …

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nitric oxide Epoprostenol

Nitric Oxide and Epoprostenol (Flolan) Use in Cardiac Surgery

We all wish that every patient who goes into cardiac surgery would be a straight-forward fast track case. Unfortunately, the issues that lead most patients to need cardiac surgery also put them at risk for complications. Some patients present with pulmonary hypertension that is discovered in the operating room once the pulmonary artery catheter is …

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Cardiogenic Shock per the American Heart Association (AHA)

This an open access from the AHA regarding management of Cardiogenic Shock. This is good stuff. There's nothing brand new (to me at least) but it's always good have the (mostly) updated data in one place. Of course, I'm solely going to touch on the topics of Medical Management because I can't perform PCI nor …

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