Episode 188: Vasopressors
We go over the essential and complex topic of vasopressors in the ED.
Hosts:
Brian Gilberti, MD
Catherine Jamin, MD
Show Notes
Introduction
- Host: Brian Gilberti, MD
- Guest: Catherine Jamin, MD
- Associate professor of Emergency Medicine at NYU Langone Health
- Vice Chair of Operations
- Triple-boarded in Emergency Medicine, Internal Medicine, and Critical Care Medicine
- Topic: Vasopressors: Essential agents for supporting critically ill patients in the ED
What Are Vasopressors and When to Use Them
- Two primary mechanisms to increase blood pressure:
- Increasing systemic vascular resistance via vasoconstriction
- Increasing cardiac output via augmenting inotropy and chronotropy
- Indicators for vasopressor use:
-
- MAP
- Signs of organ dysfunction like altered mental status, decreased urine output, elevated lactate
- Fluid resuscitation either ineffective or contraindicated (e.g., in CHF patients)
Commonly Used Vasopressors in the ED
- Norepinephrine
- Epinephrine
- Vasopressin
- Phenylephrine
Norepinephrine
- Mechanism: Stimulates alpha-1 (vasoconstriction) and beta-1 receptors (increases in...