Rebellion21: Vasopressors – When and Why via Haney Mallemat, MD

In this 14-minute presentation from Rebellion in EM 2021, Dr. Haney Mallemat, using his chalk talk CritBits style, discusses the various vasopressors and their pros/cons.

Haney Mallemat, MD
Emergency Medicine/Critical Care
Associate Professor
Cooper University Health Care
Twitter: @CriticalCareNow

Objectives

1. Outline the various vasopressors available
2. Discuss the clinical situations when to use specific vasopressors

Vasopressors:

• Dopamine – Pressor looking for an indication
• Phenylephrine – Alpha agonist; Vasoconstriction; Can decrease CO
• Epinephrine – Alpha/Beta agonist; Lower doses Beta > Alpha; Higher doses Alpha > Beta; Can cause arrhythmias and type B lactic acidosis; Consider 1^st line in status asthmaticus and anaphylactic shock
• Norepinephrine – Alpha/Beta agonist; Increases arterial/venous tone and can increase pulmonary vascular resistance; Consider 1^st line in septic shock
• Vasopressin – V1 receptor agonist; Less likely to increase pulmonary vascular resistance compared to other vasopressors
• Angiotensin II – Very expensive; Not readily available; Studied in sepsis and distributive shock

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)