Hi all,
My name is James, I am an advanced life support paramedic. I am currently doing my Masters in medical education. I am passionate about EMS and make these video's purely because I enjoy doing so and in the hopes that you all will enjoy them.
I still find it confusing, which one is which. Alpha or beta. I found making this helpful.
Vasopressors and Inotropes explained in a helpful way.
Research:
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Dopamine vs NE: Same death rate, but dopamine had more negative effects.
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Prehospital Resuscitation with Phenylephrine in Uncontrolled Hemorrhagic Shock and Brain Injury
Phen vs LR, LR has less secondary effects. (better blood to brain)
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In shock, dopamine does no naturally increase. Adrenaline and NE do.
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CardShock study
cardiogenic shock - adrenaline use is associated with excess organ injury and mortality
adrenaline was independently associated with 90-day mortality in CS
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meta analysis of RCT
At present there are no robust and convincing data to support a distinct inotropic or vasodilator drug based therapy as a superior solution to reduce mortality in haemodynamically unstable patients with CS or low cardiac output complicating AMI.
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Despite the frequent use of catecholamines which are administered in ∼90% of patients in CS,7 there is only limited evidence from randomized trials comparing catecholamines in CS. Furthermore, despite beneficial effects on haemodynamics, there are no randomized data showing a prognostic benefit.
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adrenaline in CA, no improvement, only better rosc
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We found no evidence of substantial differences in total mortality between several vasopressors.
RCT meta analysis
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Survival After Shock Requiring High-Dose Vasopressor Therapy more than 1mcg/kg/min (normal 0.01-0.03)
One in six patients with shock survived to 90 days after HDV
