Tag: hypotension
Personalization of Arterial Pressure in the Perioperative Period
This review aims to discuss recent findings on the relationship between intraoperative arterial hypotension and organ dysfunction in surgical patients and examines the available evidence for personalizing blood pressure (BP)... read more
Expanding the Differential for Hypotension in the Pediatric Patient
As many ED practitioners are aware, food allergies are common in the first 2 years of life, with a prevalence cited between 1-10% of the population. Most food allergies are IgE-mediated hypersensitivity reactions. Food protein-induced... read more
Tranexamic Acid For Isolated Penetrating Head Trauma
An aeromedical crew was dispatched to a local emergency department to transport a fourteen year-old female with self-inflicted gunshot wound to the head to a tertiary pediatric trauma hospital. The patient was previously... read more
Echocardiography and Lung Ultrasonography for the Assessment and Management of AHF
Echocardiography is increasingly recommended for the diagnosis and assessment of patients with severe cardiac disease, including acute heart failure (AHF). Echocardiography and LUS can assist in the rapid assessment of patients... read more
The Shocked Intubation: Definitive Airway Sans Hypotension
Not many aspects of Emergency Medicine define our specialty better than resuscitation, and few concepts exemplify resuscitation better than shock and intubation. Yet few words together strike greater fear in the minds of... read more
Postoperative Renal Dysfunction After Noncardiac Surgery
Acute kidney injury (AKI) is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures.... read more
Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TBI
Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic... read more
Effect of Targeted Polymyxin B Haemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level
In adult patients with septic shock and high circulating endotoxin activity, does the use of polymyxin B hemoperfusion therapy significantly decrease 28-day mortality? Among patients with septic shock and high endotoxin activity,... read more
Approach to the Critically Ill Child: Shock
If you mainly treat adults or both adults and children like me, then you have probably heard the (very annoying) quote, "kids are not just small adults", and so I won't say it again. Well, I guess I just did, but at least... read more
Magnesium Sulfate for Rapid Atrial Fibrillation?
Currently, several medications are recommended for the management of atrial fibrillation with rapid ventricular response in the emergency department including calcium channel blockers, beta blockers and digoxin (the optimal... read more
Update on Perioperative Acute Kidney Injury
Acute kidney injury (AKI) in the perioperative period is a common complication and is associated with increased morbidity and mortality. A standard definition and staging system for AKI has been developed, incorporating a... read more
Intensive Care Medicine in 2050: Vasopressors in Sepsis
Vasopressors are used in sepsis when hypotension is assumed to be mainly due to a decreased arterial tone. However, the appropriate time to initiate vasopressors is not clearly defined, and fluid administration is most... read more
Hemodynamic Tolerance to IV Clonidine Infusion in the PICU
Although administration of clonidine is often associated with bradycardia and hypotension, these complications do not seem clinically significant in a mixed PICU population with a high degree of disease severity. Clonidine... read more
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock
Effective antimicrobial administration within the first hour of documented hypotension was associated with increased survival to hospital discharge in adult patients with septic shock. Despite a progressive increase in mortality... read more
Low-dose vs. High-dose Magnesium in Rapid Afib
Magnesium sulfate has been used as an adjunct medication for the treatment of atrial fibrillation (AF) due to its ability to lessen sinus node depolarization via calcium antagonism. Prior studies investigating magnesium in... read more
MAP of 65: Target of the Past?
Septic shock is defined as sepsis with hypotension refractory to fluid challenge and requiring vasopressor support combined with an increase in arterial lactate reflecting impaired cellular energy metabolism and dysoxia.... read more
Vascular Effects of Adrenomedullin and the Anti-Adrenomedullin Antibody Adrecizumab in Sepsis
Sepsis remains a major scientific and medical challenge, for which, apart from significant refinements in supportive therapy, treatment has barely changed over the last few decades. During sepsis, both vascular tone and vascular... read more
What’s New in Severe Pulmonary Embolism?
Severe pulmonary embolism (PE) remains a major cause of mortality. For intensivists managing the most "severe" forms of PE, we highlight the main recent advances in the care of such patients including risk stratification,... read more
The Myth of Vasopressors and Ischemia
Despite the widespread clinical use, and their well-documented life-saving properties, vasopressors are often maligned, accused of causing ischemia to fingers, toes, mesentery, kidneys, and so forth. Not only is the evidence... read more
The Relationship Between ICU Hypotension and In-hospital Mortality and Morbidity in Septic Patients
Current guidelines recommend maintaining a mean arterial pressure (MAP)≥ 65 mmHg in septic patients. However, the relationship between hypotension and major complications in septic patients remains unclear. We, therefore,... read more
Incidence of hypotension according to the discontinuation order of vasopressors in the management of septic shock
Tapering NE rather than AVP may be associated with a higher incidence of hypotension in patients recovering from septic shock who are on concomitant NE and AVP. However, further studies with larger sample sizes are required... read more
Vasopressors for Hypotensive Shock
This review seeks unbiased evidence about the effects of different drugs that enhance blood pressure on risk of dying in critically ill patients with impaired blood circulation. Review authors identified 28 randomized controlled... read more
