SCCM Resource Library-May Journal Club: Spotlight on Pharmacy (2022)

Video Transcription

Video Summary

In this video, three presenters discuss various topics related to critical care pharmacy. The first presenter discusses a recent trial comparing epinephrine and norepinephrine in cardiac arrest patients with post-resuscitation shock. The presenter discusses the mortality rate in out-of-hospital cardiac arrest, the causes of death, and the optimal hemodynamic support for post-cardiac arrest patients. The presenter highlights the lack of randomized control trials comparing vasopressor agents in this population and discusses the potential risks and benefits of epinephrine and norepinephrine. The second presenter discusses a recent study on the timing of hydrocortisone initiation in septic shock patients. The presenter provides an overview of the current guidelines for corticosteroid use in septic shock and the evidence supporting hydrocortisone use. The presenter then presents the study, which compares early versus late initiation of hydrocortisone in septic shock patients. The presenter discusses the study's methodology, including the inclusion and exclusion criteria, and the primary and secondary outcomes. The presenter presents the results of the study, including the difference in vasopressor duration between the early and late initiation groups. The presenter concludes that while earlier initiation of hydrocortisone may lead to a shorter duration of vasopressor use, the impact on mortality is still unclear. The third presenter discusses a study evaluating the impact of angiotensin II on patient outcomes in the medical ICU. The presenter provides background information on the use of vasopressors in septic shock and the different mechanisms of action of vasopressors. The presenter then presents the study, which compares the addition of angiotensin II to a non-angiotensin II agent as a third-line vasopressor in patients with catecholamine refractory septic shock. The presenter discusses the study's methodology, including the inclusion and exclusion criteria, and the primary and secondary outcomes. The presenter presents the results of the study, including the lack of significant difference in mortality or other patient-centered outcomes between the angiotensin II and non-angiotensin II groups. The presenter concludes that while the addition of angiotensin II did not significantly influence mortality or other outcomes in this study, further research is needed to define the patient populations most likely to benefit from angiotensin II. In summary, the presenters discuss the use of different vasopressors in critical care settings and present the results of recent studies evaluating their efficacy and safety. They highlight the need for further research to guide vasopressor selection and timing of initiation in specific patient populations.

Asset Subtitle

Pharmacology, Cardiovascular, Sepsis, 2022

Asset Caption

"The Journal Club: Spotlight on Pharmacy webcast series focuses on pharmacy topics. This event is held on the third Friday of each month and features lively discussion and in-depth presentations on the latest research.

Blake Robbins, PharmD, MBA
Bougouin W, Slimani K, Renaudier M, et al. Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022 Mar;48(3):300-310.

Erica Allen, PharmD
Ragoonanan D, Allen B, Cannon C, Rottman-Pietrzak K, Bello A. Comparison of early versus late initiation of hydrocortisone in patients with septic shock in the ICU setting. Ann Pharmacother. 2022 Mar;56(3):264-270.

Marjorie Peck, PharmD, BS
Quan M, Cho N, Bushell T, et al. Effectiveness of angiotensin II for catecholamine refractory septic or distributive shock on mortality: a propensity score weighted analysis of real-world experience in the medical ICU. Crit Care Explor. 2022 Jan 18;4(1):e0623.

Follow the conversation at #SCCMCPPJC."

Meta Tag

Content Type Webcast

Knowledge Area Pharmacology

Knowledge Area Cardiovascular

Knowledge Area Sepsis

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Tag Pharmacology

Tag Cardiac Arrest

Tag Shock

Year 2022

Keywords

critical care pharmacy

epinephrine

norepinephrine

cardiac arrest

post-resuscitation shock

mortality rate

hemodynamic support

vasopressor agents

hydrocortisone initiation

septic shock

angiotensin II

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.