Critical Care Time REBOOTED - 7. Vasopressors - Part 2
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Oct 21, 2024 Explore advanced strategies for managing vasopressors in critically ill patients, including titration techniques and effective weaning methods. The humor shines through as personal stories of pickleball transform into car troubles. Delve into the complexities of septic shock and the role of angiotensin II, while also understanding the importance of continuous monitoring. Discover the challenges in weaning patients off vasopressors and the significance of patient mobilization. A blend of critical insights and light-hearted anecdotes make for an engaging listen!
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Ms. G's Deterioration
- Ms. G's blood pressure dropped despite being on norepinephrine and vasopressin.
- She became less responsive and her urine output decreased, indicating worsening condition.
Corticosteroids in Sepsis
- Corticosteroids increase adrenergic receptor transcription, improving vasopressor response.
- Recent trials show improved survival with steroids in septic shock, pneumonia, and COVID-19.
Refractory Shock
- There's no true max norepinephrine dose; higher doses have diminishing returns due to receptor saturation.
- Rule out other issues when vasopressors seem ineffective.