Episode 913: Vasopressors after ROSC

Episode 913: Vasopressors after ROSC

Contributor: Travis Barlock MD

Educational Pearls:

  • Recent study assessed outcomes after ROSC with epinephrine vs. norepinephrine

    • Observational multicenter study from 2011-2018

    • 285 patients received epineprhine and 481 received norepinephrine

  • Epinephrine was associated with an increase in all-cause mortality (primary outcome)

    • Odds ratio 2.6; 95%CI 1.4-4.7; P = 0.002

    • Higher cardiovascular mortality (secondary outcome)

    • Higher proportion of unfavorable neurological outcome (secondary outcome)

  • Norepinephrine is the vasopressor of choice in post-cardiac arrest care

References

  1. Bougouin W, Slimani K, Renaudier M, et al. Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022;48(3):300-310. doi:10.1007/s00134-021-06608-7

Summarized by Jorge Chalit, OMSIII | Edited by Meg Joyce & Jorge Chalit

Jaksot(1144)

Episode 904: Cardiovascular Risks of Epinephrine

Episode 904: Cardiovascular Risks of Epinephrine

Contributor: Aaron Lessen MD Educational Pearls: Epinephrine is essential in the treatment of anaphylaxis, but is epinephrine dangerous from a cardiovascular perspective? A 2024 study in the Journal o...

20 Touko 20242min

Episode 903: Treating Precipitated Opioid Withdrawal

Episode 903: Treating Precipitated Opioid Withdrawal

Contributor: Aaron Lessen MD Educational Pearls: Opioid overdoses that are reversed with naloxone (Narcan), a mu-opioid antagonist, can precipitate acute withdrawal in some patients Treatment of o...

13 Touko 20242min

Episode 902: Liver Failure and Cirrhosis

Episode 902: Liver Failure and Cirrhosis

Contributor: Travis Barlock MD Educational Pearls: How do you differentiate between compensated and decompensated cirrhosis? Use the acronym VIBE to look for signs of being decompensated. V-Volume ...

6 Touko 20243min

Episode 901: Underdosing in Status Epilepticus

Episode 901: Underdosing in Status Epilepticus

Contributor: Aaron Lessen MD Educational Pearls: Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus Some ED protocols only give 2 mg initially The maximum r...

29 Huhti 20242min

Episode 900: Ketamine Dosing

Episode 900: Ketamine Dosing

Contributor: Travis Barlock MD Educational Pearls: Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3....

22 Huhti 20242min

Episode 899: Thrombolytic Contraindications

Episode 899: Thrombolytic Contraindications

Contributor: Travis Barlock MD Educational Pearls: Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes Use of anticoagulants with INR > 1.7 or  PT >15 Warfarin will reliably i...

15 Huhti 20243min

Episode 898: Takotsubo Cardiomyopathy

Episode 898: Takotsubo Cardiomyopathy

Contributor: Ricky Dhaliwal, MD Educational Pearls: Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a temporary heart condition that can mimic the symptoms of a heart attack, inc...

10 Huhti 20243min

Episode 897: Adrenal Crisis

Episode 897: Adrenal Crisis

Contributor: Ricky Dhaliwal MD Educational Pearls: Primary adrenal insufficiency (most common risk factor for adrenal crises) An autoimmune condition commonly known as Addison's Disease Defects...

1 Huhti 20244min

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