Artwork

内容由medicalminute and Emergency Medical Minute提供。所有播客内容(包括剧集、图形和播客描述)均由 medicalminute and Emergency Medical Minute 或其播客平台合作伙伴直接上传和提供。如果您认为有人在未经您许可的情况下使用您的受版权保护的作品,您可以按照此处概述的流程进行操作https://zh.player.fm/legal
Player FM -播客应用
使用Player FM应用程序离线!

Episode 904: Cardiovascular Risks of Epinephrine

2:11
 
分享
 

Manage episode 419210829 series 1397179
内容由medicalminute and Emergency Medical Minute提供。所有播客内容(包括剧集、图形和播客描述)均由 medicalminute and Emergency Medical Minute 或其播客平台合作伙伴直接上传和提供。如果您认为有人在未经您许可的情况下使用您的受版权保护的作品,您可以按照此处概述的流程进行操作https://zh.player.fm/legal

Contributor: Aaron Lessen MD

Educational Pearls:

Epinephrine is essential in the treatment of anaphylaxis, but is epinephrine dangerous from a cardiovascular perspective?

A 2024 study in the Journal of the American College of Emergency Physicians Open sought to answer this question.

Methods:

  • Retrospective observational study at a Tennessee quaternary care academic ED that analyzed ED visits from 2017 to 2021 involving anaphylaxis treated with IM epinephrine.

  • The primary outcome was cardiotoxicity

Results:

  • Out of 338 patients, 16 (4.7%) experienced cardiotoxicity. Events included ischemic EKG changes (2.4%), elevated troponin (1.8%), atrial arrhythmias (1.5%), ventricular arrhythmia (0.3%), and depressed ejection fraction (0.3%).

  • Affected patients were older, had more comorbidities, and often received multiple epinephrine doses.

Bottom line:

  • All adults presenting with anaphylaxis should be rapidly treated with epinephrine but monitored closely for cardiotoxicity, especially in patients with a history of hypertension and those who receive multiple doses.

These results are supported by a 2017 study that found that 9% (4/44) of older patients who received epinephrine for anaphylaxis had cardiovascular complications.

References

  1. Kawano, T., Scheuermeyer, F. X., Stenstrom, R., Rowe, B. H., Grafstein, E., & Grunau, B. (2017). Epinephrine use in older patients with anaphylaxis: Clinical outcomes and cardiovascular complications. Resuscitation, 112, 53–58. https://doi.org/10.1016/j.resuscitation.2016.12.020

  2. Pauw, E. K., Stubblefield, W. B., Wrenn, J. O., Brown, S. K., Cosse, M. S., Curry, Z. S., Darcy, T. P., James, T. E., Koetter, P. E., Nicholson, C. E., Parisi, F. N., Shepherd, L. G., Soppet, S. L., Stocker, M. D., Walston, B. M., Self, W. H., Han, J. H., & Ward, M. J. (2024). Frequency of cardiotoxicity following intramuscular administration of epinephrine in emergency department patients with anaphylaxis. Journal of the American College of Emergency Physicians open, 5(1), e13095. https://doi.org/10.1002/emp2.13095

Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit OMS II

  continue reading

1057集单集

Artwork
icon分享
 
Manage episode 419210829 series 1397179
内容由medicalminute and Emergency Medical Minute提供。所有播客内容(包括剧集、图形和播客描述)均由 medicalminute and Emergency Medical Minute 或其播客平台合作伙伴直接上传和提供。如果您认为有人在未经您许可的情况下使用您的受版权保护的作品,您可以按照此处概述的流程进行操作https://zh.player.fm/legal

Contributor: Aaron Lessen MD

Educational Pearls:

Epinephrine is essential in the treatment of anaphylaxis, but is epinephrine dangerous from a cardiovascular perspective?

A 2024 study in the Journal of the American College of Emergency Physicians Open sought to answer this question.

Methods:

  • Retrospective observational study at a Tennessee quaternary care academic ED that analyzed ED visits from 2017 to 2021 involving anaphylaxis treated with IM epinephrine.

  • The primary outcome was cardiotoxicity

Results:

  • Out of 338 patients, 16 (4.7%) experienced cardiotoxicity. Events included ischemic EKG changes (2.4%), elevated troponin (1.8%), atrial arrhythmias (1.5%), ventricular arrhythmia (0.3%), and depressed ejection fraction (0.3%).

  • Affected patients were older, had more comorbidities, and often received multiple epinephrine doses.

Bottom line:

  • All adults presenting with anaphylaxis should be rapidly treated with epinephrine but monitored closely for cardiotoxicity, especially in patients with a history of hypertension and those who receive multiple doses.

These results are supported by a 2017 study that found that 9% (4/44) of older patients who received epinephrine for anaphylaxis had cardiovascular complications.

References

  1. Kawano, T., Scheuermeyer, F. X., Stenstrom, R., Rowe, B. H., Grafstein, E., & Grunau, B. (2017). Epinephrine use in older patients with anaphylaxis: Clinical outcomes and cardiovascular complications. Resuscitation, 112, 53–58. https://doi.org/10.1016/j.resuscitation.2016.12.020

  2. Pauw, E. K., Stubblefield, W. B., Wrenn, J. O., Brown, S. K., Cosse, M. S., Curry, Z. S., Darcy, T. P., James, T. E., Koetter, P. E., Nicholson, C. E., Parisi, F. N., Shepherd, L. G., Soppet, S. L., Stocker, M. D., Walston, B. M., Self, W. H., Han, J. H., & Ward, M. J. (2024). Frequency of cardiotoxicity following intramuscular administration of epinephrine in emergency department patients with anaphylaxis. Journal of the American College of Emergency Physicians open, 5(1), e13095. https://doi.org/10.1002/emp2.13095

Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit OMS II

  continue reading

1057集单集

所有剧集

×
 
Loading …

欢迎使用Player FM

Player FM正在网上搜索高质量的播客,以便您现在享受。它是最好的播客应用程序,适用于安卓、iPhone和网络。注册以跨设备同步订阅。

 

快速参考指南