SCCM Resource Library-Vasopressors in Hemorrhagic Shock?

Video Transcription

Video Summary

Dr. Matthew Lissauer, acute care surgery chief at Hartford HealthCare and Hartford Hospital, discussed the use of vasopressors in the management of hemorrhagic shock. Traditionally, the use of pressors in trauma patients was considered a sign of missed resuscitation targets or ongoing bleeding. However, with advancements in resuscitation techniques, the need for pressors has decreased. Early blood product administration and a balanced approach to resuscitation have improved outcomes. In hemorrhagic shock, there is an early rise in vasopressin and catecholamine levels, but vasopressin levels drop quickly, leaving patients in a vasopressin-deficient state. Animal studies have shown that vasopressin administration improves survival in hemorrhagic shock. Human studies have had mixed results, with some showing a decrease in blood product utilization and others showing an association with increased mortality. Further research is needed to determine the role of vasopressors, particularly vasopressin, as an adjunct to resuscitation in trauma patients. Other pressors, such as norepinephrine, may be necessary in certain situations but may not be appropriate as an adjunct in the trauma bay. Overall, the use of vasopressors in trauma is still a topic of debate and further studies are needed to establish their role in hemorrhagic shock resuscitation.

Asset Subtitle

Trauma, Cardiovascular, Pharmacology, 2022

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2022 Critical Care Congress held from April 18-21, 2022.

Meta Tag

Content Type Presentation

Knowledge Area Trauma

Knowledge Area Cardiovascular

Knowledge Area Pharmacology

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Hemorrhage

Tag Shock

Tag Vasoactive Agents

Year 2022

Keywords

vasopressors

hemorrhagic shock

resuscitation

blood product administration

trauma patients

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