In this post, I excerpt the section, occult causes of non-response to vasopressors (0:54-7:44), from EM Quick Hits 29* by Dr. Anand Swaminathan.
*Helman, A. Swaminathan, A. Long, B. Gottlieb, M. Reid, S. Rosenberg, H. Cheskes, L. Morgenstern, J. EM Quick Hits 29 – Vasopressor Failure, Asplenic Considerations, Bronchiolitis Update, ICD Electrical Storm, Night Shift Tips. Emergency Medicine Cases. June, 2021. https://emergencymedicinecases.com/em-quick-hits-june-2021/. Accessed 9-25-2021.
All that follows is from the above resource.
Occult causes of non-response to vasopressors
- Primary therapy for hypotension is to treat the underlying cause, while initiation of vasopressors is a temporary adjunctive therapy
- Despite substantial vasopressor doses, some patients may not respond appropriately with improvements in hemodynamic parameters; failure to respond should lead to a cognitive pause and consideration of the occult causes of non-response to vasopressors.
Anand Swaminathan, “Occult Causes of Non-Response to Vasopressors”, REBEL EM blog, July 13, 2017. Available at: https://rebelem.com/occult-causes-of-non-response-to-vasopressors/.