PeaceHealth Southwest Hospital/Carson Tahoe Medical Center

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Presentation transcript:

PeaceHealth Southwest Hospital/Carson Tahoe Medical Center

Shock Defined

Cardiogenic Shock

Hypovolemic Shock

Obstructive Shock

Distributive Shock

Septic Shock

Post Cardiac Surgery Vasoplegia*

Emory Healthcare

Why Multimodal Shock Therapy?

Why Multimodal Shock Therapy?

Emory Healthcare Angiotensin II Protocol

Emory Healthcare Angiotensin II Protocol (cont)

Emory Healthcare Angiotensin II Protocol (cont)

The Emory Protocol

Emory Protocol Vasopressor Titration

Why This Protocol?

Issues With Protocol Implementation

George Washington University Hospital

Initial Assessment to Identify Type of Shock

Types of Shock

2018 SSC Bundle Update Hour-1

Vasopressors to Reach MAP ≥ 65 mm Hg

Organ Support

Hypovolemic Shock

Obstructive Shock

Cardiogenic Shock

Vasopressors in Cardiogenic Shock

Mayo Clinic

Mayo Clinic Patients Admitted to ICU Clinical Characteristics

ICU Patients on Vasopressors

Vasopressor Utilization Index (VUI)

VUI 2007 to 2013

Changes of VUI Temporal Relationship With Clinical Trials

Use of Different Vasopressor Based on the ICU Type

Trends of Specific Vasopressor Use

Use of Low-Dose Dopamine Dopamine Dose < 3 mcg/kg/min

Mayo Clinic Approach to Vasopressor Utilization: Steps to Be Taken Before Using Angiotensin II

1. Defining Refractory Distributive Shock

2. Ruling Out Cardiogenic Shock

3. Dose & Titration

4. Weaning Angiotensin II

Abbreviations

Abbreviations (cont)