hemodynamics

Anesthetic Considerations For Cardiac Compression And Tamponade

Over the course of my training as a cardiac anesthesiologist and intensivist, I've come across many manifestations of cardiac compression ranging from hemorrhagic pericardial effusions to massive clots. Although the general teaching is to...

Nitric Oxide

Nitric oxide is a molecule normally made by vascular endothelial cells to decrease vascular resistance in both the systemic and pulmonary circulations. Inhaled nitric oxide (iNO) is an (expensive) pulmonary dilator I frequently use...

Do You Titrate Vasopressin?

Compared to catecholamine infusions which are routinely titrated, there's a polarized practice with vasopressin - those who titrate and those who don't. As a resident, I worked with intensivists who strongly believed in "0.04...

Positive End Expiratory Pressure (PEEP) and Cardiac Output

One of the cardiopulmonary challenges I constantly face as a cardiothoracic anesthesiologist and intensivist is balancing positive end-expiratory pressure (PEEP) with cardiac output (CO). CO is related to the heart rate (HR) and stroke...

High Dose Fentanyl Induction

The induction of general anesthesia in patients undergoing cardiac surgery is often times different than non-cardiac surgery. At many institutions, these inductions tend to center heavily around high dose opioids due to the hemodynamic...

Cyanokit

Cyanokit (hydroxocobalamin, a form of vitamin B12) is an injectable therapy most often used to treat cyanide toxicity. This medication readily combines with cyanide to form cyanocobalamin thereby freeing cytochrome c oxidase to proceed...

Phentolamine

Phentolamine (Regitine) is a reversible α-1 and α-2 blocker used primarily for its vasodilatory effects. When used to control hypertension, one must consider the autonomic effects of blocking these receptors. Profound vasodilation will lead to...

Sodium Nitroprusside

Sodium nitroprusside (SNP, Nipride/Nitropress) is a short-acting, intravenous antihypertensive that directly acts on venous AND arteriolar smooth muscle to cause vasodilation decreasing preload, afterload, and left ventricular (LV) impedance. As an intensivist and cardiac...

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