We've all been taught that you absolutely cannot give nitrates in Right Ventricular MI–but what is the evidence for this prohibition? Our guest today, Matt Wilkinson-Stokes, did a SR/MA demonstrating there isn't much. Let's lyse some dogma…
The Paper
What do You Think??
Please comment below and tell us whether you feel change practice after reading the paper
Now on to the Podcast
- EMCrit 373 – Mike Weinstock with another Critical Care Bounceback: “Asymptomatic Hypertension” - April 18, 2024
- EMCrit Wee – Ross Prager on 10 Heuristics for the New ICU Attending - April 13, 2024
- EMCrit 372 – FoundStab Intubation SOP - April 5, 2024
Great Episode! I have a related question with regard to RV MI and the notion that the RV is “preload dependent”. We are told that IV crystalloid administration should be used in the short term to improve preload and temporize cardiac output in the unstable hypotensive pt. What does this actually mean in practical terms? Are you infusing litres of pressurized crystalloid into the patient while they wait to go to cath lab? I assume you have a more structured/tailored approach and just wondering your thoughts on this.
i usually would just infuse 1 liter max and then switch to norepi
Do you recommend the 1 liter for end stage renal patients as well, or would you give a smaller fluid bolus before starting norepi?
Aim for RA pressure of 12-15.
I use IVC