An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
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 …
Continue reading Sepsis Induced Cardiomyopathy: A Forgotten Factor in Septic Shock
My love for ACLS goes back far in my career. I fondly recall taking an ACLS/BLS course after completing medical school and prior to starting residency. It was a small class, just a couple students. The instructor was a charismatic firefighter (who I remain friends with to this day) who noted that I was particularly …
Continue reading Vasopressin & Methylprednisolone: Time to Add Them to ACLS Protocols?
I have seen well respected clinicians provide a patient with a gastrointestinal (GI) bleed with high doses of systemic vasopressin. Throughout my three years of residency training and two years of fellowship at a well respected institution, I have not seen this used once in practice. Let's take a look at what this really means …
Continue reading GI Bleed Dose Vasopressin: Is it even a thing?
This is what I love about the community in social media. We all just push each other to be better. Rishi posted today about titratable Vasopressin and, me being the data junky that I am wanting to know every study I could possibly know under the sun, had two studies in my back pocket ready …
Continue reading Vasopressin: Titratable Doses? Monotherapy in Septic shock?