Vasoactive Drugs: Facts and Fallacies

Professor John Myburgh

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Lecture overview

Physiological facts: 

  • Haemodynamics are complex and represent a teleological neurohormonal response to stress.  
  • Defence of MAP represents the balance between the afferent and efferent circulations and the compliance of the system. 
  • Monitoring is an aid to an overall assessment that must be considered within the clinical context and patient’s trajectory of illness. 

Pharmacological facts: 

  • Catecholamines are hormones that are administered to augment inadequate endogenous responses.
  • Synthetic catecholamines have no established role in clinical practice.
  • Neurohormonal supplementation strategies have limited roles and should be confined to indications established from RCTs.
  • Non-catecholamine inodilators have not been demonstrated to improve patient-centred outcomes in critically ill patients.

Learning Objectives:
By the end of this lecture, the attendee will be able to:

  1. Understand the integration of cardiovascular physiology and pharmacology of drugs used to support the failing circulation.
  2. Recognise the limitations of derived and surrogate indices in determining haemodynamic function. 
  3. Understand the role and application of endogenous catecholamine infusions in supporting the failing circulation. 
  4. Understand the limitations of the use of synthetic vasoactive drugs in critically ill patients.

This lecture is equal to 1 CE Contact Hour, 1 CPD Point, and 1 AMA PRA Category 1 Credit

 

Additional CME Info

Release Date: February 1, 2020, Termination Date: January 31, 2023

Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of EB Medicine and Continulus. EB Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: EB Medicine designates this internet enduring material for a maximum of 1 AMA PRA Category 1 Credit™ per lecture. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Commercial Support: This activity received no commercial support.

Earning Credit: In order to earn CME credit, the participant must take the pre-test, listen to the lecture, take the CME post-test, and complete the post-test evaluation.

Duration 1 hour(s).

Lecture speaker

Professor John Myburgh

Professor John A Myburgh is Professor of Intensive Care Medicine, UNSW Sydney, Director of the Critical Care Division at the George Institute for Global Health and Senior Intensive Care Physician at the St. George Hospital, Sydney.
He has an internationally recognised reputation as a clinical researcher having conducted over 30 trials in fundamental aspects of Intensive Care Medicine including haemodynamic management, traumatic brain injury, sepsis and acute kidney injury. He established the ANZICS Clinical Trials Group with collaborators in 1994 and leads an internationally 2 recognised Intensive Care Medicine research program at the George Institute with extensive national and international networks. His research program is focussed on improving cost effective patient centred outcomes in critically ill patients through high-quality trials that are internationally generalisable.
He is a Past-President of the College of Intensive Care Medicine of Australia and New Zealand and Past Secretary General of the World Federation of Societies of Intensive and Critical Care Medicine

CME Faculty Disclosure: It is the policy of EB Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. In compliance with all ACCME Essentials, Standards, and Guidelines, all faculty for this CME activity were asked to complete a full disclosure statement. The speaker did not report any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) discussed in this educational presentation.  

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