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lunes, 13 de febrero de 2017

Epinephrine vs. atropine for bradycardic periarrest

PulmCrit
PulmCrit - February 13, 2017 - By Josh Farkas
  • "It may be useful to make a distinction between patients with stable, symptomatic bradycardia versus patients who are actively dying from bradycardia (bradycardic periarrest). The best approach to these situations is different.
  • Epinephrine may be superior for patients with bradycardic periarrest for three reasons:
    • (1) It works in a broader range of bradycardias.
    • (2) It provides more powerful hemodynamic support (chronotropy, inotropy, and vasoconstriction).
    • (3) It doesn't cause paradoxical bradycardia.
  • The best initial medical therapy for bradycardic periarrest may be push-dose epinephrine, followed by an epinephrine infusion. However, this shouldn't delay efforts to perform electrical pacing as well."