Novel Vasopressor Agent Adoption in Critically Ill Adults

Novel Vasopressor Agent Adoption in Critically Ill Adults

This study aimed to investigate the utilisation of ATII in critically ill adults undergoing vasopressor therapy. The study included patients admitted to ICUs from January 1, 2018, to December 31, 2020, who received intravenous... read more

The 1,3,5 Approach to Pediatric Cardiac Arrest

The 1,3,5 Approach to Pediatric Cardiac Arrest

While pediatric cardiac arrests are thankfully rare, their shock waves can seem incalculable. Several studies have outlined the mental health toll that these events can have on everyone involved. There is an appreciable... read more

Peri-arrest Bolus Epinephrine Practices Amongst Pediatric Resuscitation Experts

Peri-arrest Bolus Epinephrine Practices Amongst Pediatric Resuscitation Experts

In this multinational survey of pediatric resuscitation experts, endorsement of peri-arrest bolus epinephrine use was nearly universal, though a few clinicians cited lack of evidence to support this practice. There was... read more

Et Tu, Calcium?

Et Tu, Calcium?

We know our core medications for ACLS (epinephrine, amiodarone, lidocaine) but what is the role of other medications, like calcium? We know calcium can be used in the non-ACLS setting for hyperkalemia to prevent or treat... read more

Feasibility of Conservative Fluid Administration and Deresuscitation vs. Usual Care

Feasibility of Conservative Fluid Administration and Deresuscitation vs. Usual Care

A strategy of conservative fluid administration and active deresuscitation is feasible, reduces fluid balance compared with usual care, and may cause benefit or harm. In view of wide variations in contemporary clinical... read more

Subtle Presentations of Shock in the ED Setting

Subtle Presentations of Shock in the ED Setting

The patient was a 2-year-old female with a history of allergy to peanuts who was brought to the emergency department by her mother because of a complaint of allergic reaction. Twenty minutes prior to arrival, the patient... read more

Epinephrine During Resuscitation of Traumatic Cardiac Arrest and Increased Mortality

Epinephrine During Resuscitation of Traumatic Cardiac Arrest and Increased Mortality

Epinephrine administered during in-hospital resuscitation was associated with lower 7-day survival rate in patients with out-of-hospital cardiac arrest (OHCA) following trauma. While we examined the outcomes of selected... read more

Epinephrine, Inodilator, or No Inotrope in VA-ECMO Implantation

Epinephrine, Inodilator, or No Inotrope in VA-ECMO Implantation

Early epinephrine therapy within the first 24 h after cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO) was associated with poor survival compared to patients with or without any inodilator therapy.... read more

Vasoactive Medication and Randomized Clinical Trials

Vasoactive Medication and Randomized Clinical Trials

Vasoactive medication is one of the cornerstones in the treatment of critically ill patients in shock. Shock can be defined as a failure of the circulatory system to provide adequate tissue perfusion resulting in cellular... read more

Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy

Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy

Epinephrine administration by bolus resulted in transient improvements in cerebral oxygenation and metabolism, whereas continuous epinephrine infusion did not, compared with placebo. Future studies are needed to evaluate... read more

Testing Epinephrine for Out-of-Hospital Cardiac Arrest

Testing Epinephrine for Out-of-Hospital Cardiac Arrest

Despite having a powerful effect on restoring spontaneous circulation after out-of-hospital cardiac arrest, epinephrine produced only a small absolute increase in survival with no increase in favorable functional recovery... read more

Do phenylephrine and epinephrine require central access?

Do phenylephrine and epinephrine require central access?

Until recently I believed that prolonged vasopressor administration requires a central line, to avoid extravasation. I lumped together all vasopressors, treating them all as equal. I used the occurrence of an extravasation... read more

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest

In adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of... read more