Phenylephrine Citations: The Vasopressor & Inotrope Handbook

Arishi H, AlQahtani S, Tamim H, Sadat M, Alenezi FZ, Bin Humaid F, AlWehaibi W, Arabi YM. Combination of norepinephrine with phenylephrine versus norepinephrine with vasopressin in critically ill patients with septic shock: A retrospective study. J Crit Care. 2022 Dec;72:154121. doi: 10.1016/j.jcrc.2022.154121. Epub 2022 Jul 28. PMID: 35908329.Link to (NOT FREE) ArticleHawn JM, Bauer …

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Terlipressin Citations: The Vasopressor & Inotrope Handbook

1. Bernadich C, Bandi JC, Melin P, Bosch J. Effects of F-180, a new selective vasoconstrictor peptide, compared with Terlipressin and vasopressin on systemic and splanchnic hemodynamics in a rat model of portal hypertension. Hepatology 1998;27:351–356. DOI: 10.1002/hep.510270206. Link to ArticleLink to FULL FREE PDF2. Demiselle J, Fage N, Radermacher P, Asfar P. Vasopressin and its …

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phenobarbital alcohol withdrawal

Phenobarbital for Alcohol Withdrawal: Reviewing the Evidence

Have you tried to use phenobarbital for your ICU patients with alcohol withdrawal syndrome?Typically, we use benzodiazepines such as ativan to treat this.Although the empiric data is quite compelling to make the switch.I personally use phenobarbital more often than benzodiazepines these days.The main question of course is the dosing.This single-center, pre-post protocol implementation study is …

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dl vl intubation

Direct (DL) vs Video Laryngoscopy (VL) for Intubation? DEVICE Trial

Your patient needs an airway. What is your go-to tool for endotracheal intubation? Do you reach for direct laryngoscopy (DL) and just get it over with? Or do you wait until the whole setup gets brought into the room to attempt a video laryngoscopy (VL)? The debate of DL vs. VL for intubation has persisted …

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MAP cardiac arrest

MAP (Mean Arterial Pressure) Goal/Target After Cardiac Arrest

Your patient suffered a cardiac arrest and we have achieved ROSC.They are hypotensive and need vasopressors.What MAP should we target in patients after cardiac arrest?The surviving sepsis campaign likes for us to shoot for 65 in septic shock patients.Other studies have shown that patients who are chronically hypertensive could do better with 75.Current guidelines also …

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cvc platelet

Thrombocytopenia & CVC Placement: What’s the Platelet Count Threshold to Transfuse?

Your patient has thrombocytopenia (low platelet count) but also needs a central line (CVC).We do not want to do harm to our patient and cause them a bleeding complication.But what is the magic platelet count to safely perform the procedure?The authors performed a multicenter randomized controlled trial with 338 patients to find out.Hat tip to …

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sepsis induced cardiomyopathy

Sepsis Induced Cardiomyopathy: A Forgotten Factor in Septic Shock

It is my personal opinion that sepsis-induced cardiomyopathy has been under recognized and understudied. Our current practice pattern of starting patients on norepinephrine is good. But automatically going to vasopressin, then either phenylephrine or epinephrine as they continue to deteriorate overlooks the fact that they may have sepsis-induced cardiomyopathy. Going down the typical route we …

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