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Vasopressor Management in Septic Shock: Overview & Approach
Vasopressors are essential in managing septic shock by maintaining adequate perfusion pressure and organ perfusion. Initial management involves prompt recognition of septic shock and fluid resuscitation. Norepinephrine is typically the first-line vasopressor, acting through alpha-adrenergic receptors to increase systemic vascular resistance. If hypotension persists despite norepinephrine, a second-line vasopressor like vasopressin or epinephrine may be added. Dosing and titration aim to achieve a target mean arterial pressure of 65 mmHg or higher.
About the Speaker
Dr. Pooja Wadwa
Critical Care Medicine, ECMO specialist, FMRI, Gurgaon
Dr. Pooja is an Associate Consultant Critical care medicine at FMRI. She is a MD (Internal Medicine), Observer-ship, in ICU Royal Melbourne Hospital, Australia. Worked as a senior resident at Fortis Escorts Hospital, Faridabad for 2 years, Worked as a Consultant Physician in Wadwa Nursing Home, Faridabad, India from October 2009- December 2010, Worked as Consultant Physician at ESIC Hospital, Faridabad, India from May 2009- October 2009. Completed Indian Diploma in Critical Care Medicine (IDCCM) FROM Indraprastha Apollo Hospitals, New Delhi Jan 2011 Mar 2013.
Upcoming Case Discussions
New Approach of treatment of Diabetic Neuropathy
Emerging treatments for diabetic neuropathy focus on addressing the root causes and providing symptomatic relief. Novel therapies include advanced pain management drugs, nerve regeneration techniques, and the use of antioxidants like alpha-lipoic acid. Regenerative medicine approaches, such as stem cell therapy, aim to repair damaged nerves. Personalized treatment plans incorporating lifestyle changes, glycemic control, and physical therapy are gaining importance. These innovative strategies improve quality of life and target long-term nerve health in diabetic patients.
Alpha Lipoic Acid in Oxidative Stress
Alpha-lipoic acid (ALA) is a potent antioxidant that helps combat oxidative stress by neutralizing free radicals. It regenerates other antioxidants like vitamin C and E, enhancing overall antioxidant defense. ALA plays a crucial role in reducing cellular damage caused by conditions like diabetes, neuropathy, and aging. Its ability to function in both water- and fat-soluble environments makes it versatile in protecting various tissues. Regular supplementation of ALA may improve mitochondrial function and reduce inflammation associated with oxidative stress.
Evaluating Cardiac Function in Sepsis and Septic Shock
Cardiac dysfunction is common in sepsis and septic shock, requiring careful evaluation for optimal management. Echocardiography is the cornerstone for assessing myocardial function, including ejection fraction and cardiac output. It detects ventricular dilation, reduced contractility, or other abnormalities. Biomarkers like troponins and B-type natriuretic peptide (BNP) help identify myocardial injury and stress. Hemodynamic monitoring, using tools like pulmonary artery catheters or pulse contour analysis, provides insights into cardiac output and systemic vascular resistance. Early identification of cardiac dysfunction enables tailored interventions.
Clinician’s Approach to Acute Respiratory Distress Syndrome
A clinician’s approach to respiratory infections involves a thorough assessment of symptoms, patient history, and risk factors, followed by diagnostic testing such as sputum cultures, chest X-rays, or PCR tests to identify the causative pathogen. Based on the diagnosis, appropriate antimicrobial therapy, supportive care, and close monitoring for complications are initiated, with attention to managing comorbid conditions and preventing the spread of infection.
Cancer and Air Pollution: The Delhi Dilemma
Cancer and air pollution are deeply intertwined in Delhi, where pollution levels rank among the highest globally. Prolonged exposure to particulate matter and carcinogenic toxins in the air increases the risk of respiratory and lung cancers. The city's residents face a significant health burden, particularly vulnerable groups like children and the elderly. Addressing this challenge requires stringent pollution control measures, public health awareness, and policy interventions. The Delhi dilemma underscores the urgent need for sustainable urban planning and environmental regulations to protect public health.