One tricky area of emergency management is the use of pressor agents for severe hypotension. In his presentation “Under Pressor! Utilizing IV Pressors in the ED,” Peter M. DeBlieux, MD, FACEP, professor of clinical medicine and chief medical officer at University Medical Center at New Orleans, will help clear up some confusion.

Dr. DeBlieux will review the basics of blood pressure support with IV pressor agents and give take-home tips on how to manage patients with severely low blood pressure.

One specific area he will address is sepsis management of blood pressure using both norepinephrine to improve blood pressure and the inotropic agent dobutamine to improve cardiac performance. He also will cover utilization of the same two agents in the setting of cardiogenic shock as a bridge to more invasive approaches, which can include intra-aortic pump, left ventricular assist devices, coronary artery stenting, and coronary artery bypass grafting.

The presentation also will cover:

• Systolic blood pressure
• The use of mean arterial blood pressure as a goal of therapy rather than systolic blood pressure. “Mean arterial blood pressure measures more closely approximate organ perfusion pressures and are more physiologic,” Dr. DeBlieux said.
• The use of dobutamine as a vasoactive agent and not a true vasopressor
• Pulse dosing of vasopressors

Expect some take-home tips from Dr. DeBlieux, such as the importance of ultrasound with this patient group. “Bedside utilization of ultrasound should be used in close concert with vasopressor therapy to develop a treatment plan and to assess for response,” he said.

Vanessa Caceres is a freelance medical writer based in Florida.

Dr. DeBlieux

Rapid Fire: Under Pressor! Utilizing IV Pressors in the ED
Sunday, Oct. 16
11:30–11:55 a.m.
Mandalay Bay Ballroom D