Vasopressors and shock

A video for all learners about four different types of shock, the vasopressors we use, and the data behind their use.


An overview of Vasopressors and shock, feel free to leave a comment or suggestion!
Overgaard CB, Dzavik V. Inotropes and vasopressors: review of physiology and clinical use in cardiovascular disease. Circulation, 118(10), 1047-1056 (2008).

References:
DA increasing cardiac index
1. Hannemann L, Reinhart K, Grenzer O, Meier-Hellmann A, Bredle DL. Comparison of dopamine to dobutamine and norepinephrine for oxygen delivery and uptake in septic shock. Crit Care Med, 23(12), 1962-1970 (1995).
3. Guerin JP, Levraut J, Samat-Long C, Leverve X, Grimaud D, Ichai C. Effects of dopamine and norepinephrine on systemic and hepatosplanchnic hemodynamics, oxygen exchange, and energy balance in vasoplegic septic patients. Shock, 23(1), 18-24 (2005).
DA vs NE cardiogenic shock
4. De Backer D, Biston P, Devriendt J et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med, 362(9), 779-789 (2010).
5. Rui Q, Jiang Y, Chen M, Zhang N, Yang H, Zhou Y. Dopamine versus norepinephrine in the treatment of cardiogenic shock: A PRISMA-compliant meta-analysis. Medicine (Baltimore), 96(43), e8402 (2017).
EPI vs NE cardiogenic
6. Levy B, Clere-Jehl R, Legras A et al. Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction. J Am Coll Cardiol, 72(2), 173-182 (2018).
7. 60. Leopold V, Gayat E, Pirracchio R et al. Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients. Intensive Care Med, 44(6), 847-856 (2018).
PE vs NE distributive
8. Morelli A, Ertmer C, Rehberg S et al. Phenylephrine versus norepinephrine for initial hemodynamic support of patients with septic shock: a randomized, controlled trial. Crit Care, 12(6), R143 (2008).
CS shock guideline
9. van Diepen S, Katz JN, Albert NM et al. Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association. Circulation, 136(16), e232-e268 (2017).
Septic shock guideline
10. Dellinger RP, Levy MM, Rhodes A et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med, 41(2), 580-637 (2013).
11. Martin C, Papazian L, Perrin G, Saux P, Gouin F. Norepinephrine or dopamine for the treatment of hyperdynamic septic shock? Chest, 103(6), 1826-1831 (1993).
DA vs NE distributive shock
12. Patel GP, Grahe JS, Sperry M et al. Efficacy and safety of dopamine versus norepinephrine in the management of septic shock. Shock, 33(4), 375-380 (2010).
EPI vs NE distributive
13. Myburgh JA, Higgins A, Jovanovska A, Lipman J, Ramakrishnan N, Santamaria J. A comparison of epinephrine and norepinephrine in critically ill patients. Intensive Care Med, 34(12), 2226-2234 (2008).
14. Annane D, Vignon P, Renault A et al. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet, 370(9588), 676-684 (2007).
Neurogenic Shock
15. Inoue T, Manley GT, Patel N, Whetstone WD. Medical and surgical management after spinal cord injury: vasopressor usage, early surgerys, and complications. J Neurotrauma, 31(3), 284-291 (2014).
16. Readdy WJ, Whetstone WD, Ferguson AR et al. Complications and outcomes of vasopressor usage in acute traumatic central cord syndrome. J Neurosurg Spine, 23(5), 574-580 (2015).
17. Yue JK, Winkler EA, Rick JW et al. Update on critical care for acute spinal cord injury in the setting of polytrauma. Neurosurg Focus, 43(5), E19 (2017).

[muna-]

Great and helpful lecture. Many thanks.

[ColorBlind]

Great lecture and even better video, well organized and easy to follow.

You mentioned BP & SVR often get confused, but does BP have an effect on the amount of SVR you'd feel? (Will hypertension increase Dynes in the arteries?)