Subphenotyping can change answers. In CLOVERS: SP2 (“leaky endothelium”) had lower mortality with early vasopressors (restrictive fluids), while SP1 favored fluids. EUPHRATES/TIGRIS: endotoxin 0.6–0.9 subgroup signaled benefit → smarter, targeted trials. #KidneyWk #Sepsis #AKI
November 6, 2025 at 11:21 PM
New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
October 29, 2025 at 3:19 PM
New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
Such an important teaching point. In patients who respond poorly to vasopressors, always question whether the blood pressure measurement you are targeting is actually representative. #emimcc #cardiosky
ICU Snapshots:
Walking from room to room in the ICU, you see this on the monitor of a 60 yo female patient admitted the previous night with severe community-acquired pneumonia & what you were told was "refractory" septic/cardiogenic shock. Arterial line was in the R fem artery:
Walking from room to room in the ICU, you see this on the monitor of a 60 yo female patient admitted the previous night with severe community-acquired pneumonia & what you were told was "refractory" septic/cardiogenic shock. Arterial line was in the R fem artery:
September 21, 2025 at 10:55 AM
Such an important teaching point. In patients who respond poorly to vasopressors, always question whether the blood pressure measurement you are targeting is actually representative. #emimcc #cardiosky
Ten tips to optimize vasopressors use in the critically ill patient with hypotension
https://link.springer.com/content/pdf/10.1007/s00134-022-06708-y.pdf
https://link.springer.com/content/pdf/10.1007/s00134-022-06708-y.pdf
November 25, 2024 at 4:40 AM
Ten tips to optimize vasopressors use in the critically ill patient with hypotension
https://link.springer.com/content/pdf/10.1007/s00134-022-06708-y.pdf
https://link.springer.com/content/pdf/10.1007/s00134-022-06708-y.pdf
Healthcare is maxed out on vasopressors, PF ratio of 98, pH 6.9, completely clamped and mottled, no sbp, hr just dropped to 37, SPO2 53. Call the doc and RT, get the pads on and the board underneath them, and open the crash cart. They are going to code.
That's where we are in life.
That's where we are in life.
October 14, 2025 at 5:52 PM
Healthcare is maxed out on vasopressors, PF ratio of 98, pH 6.9, completely clamped and mottled, no sbp, hr just dropped to 37, SPO2 53. Call the doc and RT, get the pads on and the board underneath them, and open the crash cart. They are going to code.
That's where we are in life.
That's where we are in life.
Maybe the editors changed the title of the table from “vasoactives” to “vasopressors”?
December 28, 2024 at 8:31 PM
Maybe the editors changed the title of the table from “vasoactives” to “vasopressors”?
Don’t forget to think about the right ventricle in your critically ill patient. Don’t forget to think outside the box of just using vasopressors and inotropes to support the RV when it’s failing. There’s more we can do. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
January 25, 2025 at 10:32 AM
Don’t forget to think about the right ventricle in your critically ill patient. Don’t forget to think outside the box of just using vasopressors and inotropes to support the RV when it’s failing. There’s more we can do. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
It means many inductions are closer to RSI, because there is no waiting time and thus no need for ventilation. If you are used to maintaining cardiovascular tone with high sympathetic activity, BP/HR will drop a bit more with this technique and we ofte use vasopressors.
September 7, 2025 at 4:25 PM
It means many inductions are closer to RSI, because there is no waiting time and thus no need for ventilation. If you are used to maintaining cardiovascular tone with high sympathetic activity, BP/HR will drop a bit more with this technique and we ofte use vasopressors.
vasopressors, part 1 link to follow, phenylephrine, levophed epinephrine dopamine vasopressin etc
www.criticalcaretime.com/episodes/vas...
www.criticalcaretime.com/episodes/vas...
November 10, 2024 at 11:00 PM
vasopressors, part 1 link to follow, phenylephrine, levophed epinephrine dopamine vasopressin etc
www.criticalcaretime.com/episodes/vas...
www.criticalcaretime.com/episodes/vas...
Even though technically and in real life, the white (proximal infusion) is used, ideally vasopressors should be given through the side port of the introducer:
November 18, 2024 at 12:25 AM
Even though technically and in real life, the white (proximal infusion) is used, ideally vasopressors should be given through the side port of the introducer:
🩸 Use of dual VA #ECLS in refractory vasoplegic shock to restore adequate MAP, facilitating weaning of conventional vasopressors, normalization of lactates, improvement in tissue perfusion. Double fem/fem+ jug/fem VA + CRRT/ hemadsorption allowed to achieve combined EBF of 9.7 L/min
🔓 bit.ly/3Hi7DAp
🔓 bit.ly/3Hi7DAp
June 2, 2025 at 5:57 PM
🩸 Use of dual VA #ECLS in refractory vasoplegic shock to restore adequate MAP, facilitating weaning of conventional vasopressors, normalization of lactates, improvement in tissue perfusion. Double fem/fem+ jug/fem VA + CRRT/ hemadsorption allowed to achieve combined EBF of 9.7 L/min
🔓 bit.ly/3Hi7DAp
🔓 bit.ly/3Hi7DAp
🫀 Haemodynamic collapse after ICU intubation: remember all the key mechanisms.
• Hypovolaemia
• LV/RV dysfunction
• Drug-induced vasodilation
• Transition to positive pressure ventilation
Optimise fluids & vasopressors early.
#Airway #ICU
👉 www.bjaed.org/article/S205...
• Hypovolaemia
• LV/RV dysfunction
• Drug-induced vasodilation
• Transition to positive pressure ventilation
Optimise fluids & vasopressors early.
#Airway #ICU
👉 www.bjaed.org/article/S205...
Airway management in critically ill patients
Airway management in the critically ill patient is a challenging task, with an estimated 45% risk of adverse events. Cardiovascular collapse (defined in most studies as a systolic pressure <65 mmHg…
www.bjaed.org
September 18, 2025 at 10:15 AM
🫀 Haemodynamic collapse after ICU intubation: remember all the key mechanisms.
• Hypovolaemia
• LV/RV dysfunction
• Drug-induced vasodilation
• Transition to positive pressure ventilation
Optimise fluids & vasopressors early.
#Airway #ICU
👉 www.bjaed.org/article/S205...
• Hypovolaemia
• LV/RV dysfunction
• Drug-induced vasodilation
• Transition to positive pressure ventilation
Optimise fluids & vasopressors early.
#Airway #ICU
👉 www.bjaed.org/article/S205...
I completely agree that if this was entirely driven by a reduction in vasopressors then this is more of a process measure than a patient centred outcome, but the supplement suggests ventilation and RRT were also reduced
October 29, 2025 at 6:48 PM
I completely agree that if this was entirely driven by a reduction in vasopressors then this is more of a process measure than a patient centred outcome, but the supplement suggests ventilation and RRT were also reduced
Another study to help set the scene for future working determining optimal MAP targets in ICU patients on vasopressors just published. #MegaMAP
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
Mean arterial pressure in critically ill adults receiving vasopressors: A multicentre, observational study
Mean arterial pressure (MAP) management is a key aspect of treatment in critically ill patients receiving vasopressor therapy. Guidelines in different…
www.sciencedirect.com
March 13, 2025 at 8:57 PM
Another study to help set the scene for future working determining optimal MAP targets in ICU patients on vasopressors just published. #MegaMAP
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
16 variables including intraoperative physiologic time series, total dose of IV fluid and vasopressors extracted for every 15-minute epoch. The model replicated 69% of physician's decisions for the dosage of vasopressors and proposed higher or lower [5/8 of https://arxiv.org/abs/2505.21596v1]
May 29, 2025 at 6:16 AM
16 variables including intraoperative physiologic time series, total dose of IV fluid and vasopressors extracted for every 15-minute epoch. The model replicated 69% of physician's decisions for the dosage of vasopressors and proposed higher or lower [5/8 of https://arxiv.org/abs/2505.21596v1]
and risk of major adverse kidney events at 7 days. However, ATII patients with prior exposure to renin angiotensin aldosterone system inhibitors had a lower peak serum creatinine than conventional vasopressors patients, and serum troponin elevations were less common with ATII
November 23, 2024 at 4:20 AM
and risk of major adverse kidney events at 7 days. However, ATII patients with prior exposure to renin angiotensin aldosterone system inhibitors had a lower peak serum creatinine than conventional vasopressors patients, and serum troponin elevations were less common with ATII
My impression of vasopressors was that until 21st century it was all Dopamine and now all NorEpi. Is my impression true?
@JohnGreenwoodMD
@JohnGreenwoodMD
December 5, 2024 at 7:57 PM
My impression of vasopressors was that until 21st century it was all Dopamine and now all NorEpi. Is my impression true?
@JohnGreenwoodMD
@JohnGreenwoodMD
#smaccGOLD @cliffreid: fallacy: vasopressors can only be delivered via central line. It's ok to start peripherally, don't delay for CL
December 1, 2024 at 11:29 AM
#smaccGOLD @cliffreid: fallacy: vasopressors can only be delivered via central line. It's ok to start peripherally, don't delay for CL
Patient (BMI: 60) is recovering from UTI-septic shock (GNR bacteremia), is on small dose of vasopressors, waking up, diuresing well. Vent: FiO2 50% - PEEP 12
July 30, 2025 at 12:11 AM
Patient (BMI: 60) is recovering from UTI-septic shock (GNR bacteremia), is on small dose of vasopressors, waking up, diuresing well. Vent: FiO2 50% - PEEP 12
RS 11a
Clinicians must ensure that the pt is not hypotensive before performing a BD/DNC exam. iv administration of volume (crystalloid or colloid), with vasopressors or inotropes as needed for management of blood pressure, before or during BD/DNC evaluation, may facilitate this
Clinicians must ensure that the pt is not hypotensive before performing a BD/DNC exam. iv administration of volume (crystalloid or colloid), with vasopressors or inotropes as needed for management of blood pressure, before or during BD/DNC evaluation, may facilitate this
November 18, 2024 at 3:24 AM
RS 11a
Clinicians must ensure that the pt is not hypotensive before performing a BD/DNC exam. iv administration of volume (crystalloid or colloid), with vasopressors or inotropes as needed for management of blood pressure, before or during BD/DNC evaluation, may facilitate this
Clinicians must ensure that the pt is not hypotensive before performing a BD/DNC exam. iv administration of volume (crystalloid or colloid), with vasopressors or inotropes as needed for management of blood pressure, before or during BD/DNC evaluation, may facilitate this
Out now, #PMT #JPharmTechnol, 2024 issue 40(1), covering topics from drug dosing (PM #hypertension dosing, #antibiotic DUEs, weight-based vasopressors, excess gabapentin dosing w/CrCl) to #drugsafety (hypoglycemia from tigecycline, #druginteractions w/apixaban).
journals.sagepub.com/toc/pmta/40/1
journals.sagepub.com/toc/pmta/40/1
February 9, 2024 at 12:15 PM
Out now, #PMT #JPharmTechnol, 2024 issue 40(1), covering topics from drug dosing (PM #hypertension dosing, #antibiotic DUEs, weight-based vasopressors, excess gabapentin dosing w/CrCl) to #drugsafety (hypoglycemia from tigecycline, #druginteractions w/apixaban).
journals.sagepub.com/toc/pmta/40/1
journals.sagepub.com/toc/pmta/40/1
Kinda unfair that in a whole category called “vasopressors” the one actually called “vasopressin” is only the number 2 choice of vasopressor.
April 23, 2024 at 3:40 PM
Kinda unfair that in a whole category called “vasopressors” the one actually called “vasopressin” is only the number 2 choice of vasopressor.
before organ failure eventually occurs. It’s not a condition that can be maintained indefinitely. Vasopressors, meds that help preserve blood pressure and heart function, need frequent titration. The ventilator breathing for the brain dead individual needs blood draws to make sure it’s keeping
4/6
4/6
May 15, 2025 at 9:21 PM
before organ failure eventually occurs. It’s not a condition that can be maintained indefinitely. Vasopressors, meds that help preserve blood pressure and heart function, need frequent titration. The ventilator breathing for the brain dead individual needs blood draws to make sure it’s keeping
4/6
4/6