Tag: hypotension
Management of Refractory Vasodilatory Shock
Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory... read more
Vasopressors in Sepsis in 2050
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
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
