Dobutamine - Critical Care Medications

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  • Опубліковано 29 січ 2025

КОМЕНТАРІ • 76

  • @Dianainscrubs
    @Dianainscrubs Місяць тому +1

    Nursing student here! Just found your channel while studying for Pharmacology and … it’s frickin AWESOME! Thanks for the videos 😊❤

  • @davidmbeckmann
    @davidmbeckmann 3 роки тому +28

    I consider dobutamine when septic patients will not lower their lactate. Stopped using it in chronic CHF, as there are studies showing short term benefit with increased long term mortality. I view it as whipping a horse pulling a heavy cart up a mountain. Probably better to lighten the load... also saw lots of old folks going into new atrial fibrillation ... excellent review and work! Cheers!

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +7

      Thank you again! Yeah we use it quite a bit with sepsis. I also agree that, short of quality of life improvement in palliative situations, Dobutamine isn't a viable treatment for chronic HF. More acute management and/or bridge. Love the analogy btw!

    • @Mriddick254
      @Mriddick254 Рік тому +3

      Saw the Afib right after starting the drip today

  • @JaTirk
    @JaTirk 2 роки тому

    Thanks! I have a cardiac meds quiz coming up, and I just found your page. I plan on going into ICU out of nursing school. I cant wait!

  • @amyRMA
    @amyRMA 3 місяці тому

    I love the straightforward way you explain these complicated concepts and medications! I'll be upgrading to ICU from PCU in a week, so I'm trying to get a head start on whatever I can. Thank you!

    • @ICUAdvantage
      @ICUAdvantage  2 місяці тому

      Awesome and congrats on the new ICU position! It's definitely a whole new world. I remember that transition from tele to ICU and I was shocked by how much there was. Take it day by day and when you have time, review over new things, especially new things you came across as it'll stick more and make more sense. Lot's of stuff on here to help along the way for ya and wishing you all the best!

  • @erinscheidt9836
    @erinscheidt9836 5 місяців тому

    I’ve been away from bed side for almost 2 years and am now looking to jump back in. Thank your for these videos they’ve helped me re-learn so much!

    • @ICUAdvantage
      @ICUAdvantage  4 місяці тому

      Glad you liked it and best of luck with your triumphant return! :)

  • @Abigail-emery
    @Abigail-emery 3 роки тому +4

    Transferring to CTICU from PCU so these videos could not have into my life at a better time, thank you eddie🙏🙏

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      Awesome!! Super excited for you. You are about to begin an exciting new journey. Happy you found the channel and best wishes!

    • @ellaxoxo15
      @ellaxoxo15 Рік тому

      Hey I am also about to transfer to PCU, can you please share some tips and other drips and must know info for this unit! ty so much

  • @markokrvavac9180
    @markokrvavac9180 3 роки тому +1

    i start at 11.2021 at ICU for heart operations, its is so interesting, so much to learn, and i work like 10 years now this job...and i feel like beginner..like your videos, thanks mate :) greetings from germany :)

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      Very cool and congrats on the new position! Glad you enjoy the videos and hope they have helped with your transition. Best of luck to you.

  • @corinnehasal4995
    @corinnehasal4995 3 роки тому +5

    Thank you for the video! It’s so difficult to find a good video on dobutamine.

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      You are very welcome! Glad to hear you liked it!

  • @reb1175
    @reb1175 3 роки тому +4

    Great video, our dosing in Aus is 500mg in 100mL 5% Dextrose. Interesting to see the differences in the US

  • @dominikbozoky2509
    @dominikbozoky2509 3 роки тому +2

    Great video! We mostly use Dobutamin as an inotropic support weaning the patient from the cardiopulmonary bypass after heart surgery. Or we use a combination of Adrenalin + Enoximone.

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +4

      Yes, we come across it quite often in CVICU, although I feel we get a lot of inotropic support from Epi as well.
      And another one! Enoximone. Seems like an alternative to Milrinone, although again I've never seen this one either.

  • @jennlee443
    @jennlee443 3 роки тому +17

    Great video! Used today on a patient in cardiogenic shock, EF 10%, he definitely needed it Lactic acid was 10.6. Good reviews that makes sense to me.

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      Happy to hear this! Yeah definitely sounds like your guy was needing some help. Hopefully that lactic starts coming down.

    • @imrandavis4031
      @imrandavis4031 3 роки тому

      @Ryland Ethan Instablaster :)

    • @rylandethan4949
      @rylandethan4949 3 роки тому

      @Imran Davis thanks for your reply. I got to the site on google and Im trying it out now.
      Looks like it's gonna take quite some time so I will get back to you later with my results.

    • @rylandethan4949
      @rylandethan4949 3 роки тому

      @Imran Davis It did the trick and I now got access to my account again. Im so happy!
      Thank you so much, you really help me out :D

  • @indrajeet1316
    @indrajeet1316 3 роки тому +1

    Thank ICU advantage
    Love from India

  • @carlosr.9469
    @carlosr.9469 3 роки тому

    the other day had a pt with a fixed milrinone and dobutamine rate, awaiting heart transplant. super helpful

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      Happy to hear you found this video helpful Carlos!

  • @pengseansem2505
    @pengseansem2505 Рік тому

    Great lesson, with many thanks

  • @dgmnhn2098
    @dgmnhn2098 4 місяці тому

    THANKS a LOT !❤

  • @ayanamitchell7906
    @ayanamitchell7906 2 місяці тому

    @ICUAdvantage 👋 Thanks you much for your videos🙏!!! At which facility (where) do practice medicine?

    • @ICUAdvantage
      @ICUAdvantage  2 місяці тому

      You're very welcome and really glad you like them! As for your question, feel free to shoot me an email. Obviously don't want to just post too much online.

  • @ericpang4831
    @ericpang4831 3 роки тому +9

    Great video! Could you please explain again how dopamine increases CVP and PAOP? I watched your video on dopamine and couldn't quite figure it out, so any help is much appreciated!

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +6

      Great question. I could have connected the dots better. Think alpha-1 vasoconstriction. We are decreasing the size of the tank, so whats filling that tank (blood) has less place to go. Since the venous and arterial systems are all one connected system, a decrease in volume for the blood to take up (vasoconstriction) leads to greater pressure. Typically we are focused on the MAP, but this also plays out elsewhere in the body.

  • @nbrown53
    @nbrown53 5 місяців тому

    Good lesson! Thank you !!

  • @laurenkromminga3043
    @laurenkromminga3043 3 роки тому

    I appreciate all your videos. I am an auditory learner, and I put your videos on while I do chores around the house.

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      Nice!! A lot of them work good for that. Some though I def think the drawings help 😊

  • @victorrivera8953
    @victorrivera8953 3 роки тому

    Love binge watching these videos haha

  • @趙祥元
    @趙祥元 3 роки тому +1

    Thank you a lot. Could you please make a video about norepinephrine? It seems to be first line medication in almost every type of shock.

  • @matthewshields5537
    @matthewshields5537 3 роки тому

    Great Content!

    • @ICUAdvantage
      @ICUAdvantage  2 роки тому +1

      Totally missed this comment! *facepalm*
      Thank you Matthew. Glad you liked it and thanks so much for the support!

  • @lizadickson1499
    @lizadickson1499 3 роки тому

    Great video

  • @twominuteanaesthesia
    @twominuteanaesthesia 8 місяців тому

    Good content

  • @JustAnotherTrader
    @JustAnotherTrader 3 роки тому +10

    Dobutamine vs Milrinone would be helpful.

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +4

      I do plan to cover Milrinone in a future lesson and will hit on that then! Thanks for the suggestion.

    • @JustAnotherTrader
      @JustAnotherTrader 3 роки тому

      @@ICUAdvantage Thanks!

  • @boyunkim9409
    @boyunkim9409 3 роки тому

    Thanks

  • @estebantspn5962
    @estebantspn5962 3 роки тому

    PERFECT!!

  • @minahperrine4728
    @minahperrine4728 6 місяців тому

    pmh with end stage HF, if patient started having frequent beats of VT after dobutamine drip started, what would be the intervention for that? ( I am curious what to expect)

  • @A.2.0.2.4-5
    @A.2.0.2.4-5 5 місяців тому

    ♥️👍🏼🙏🏻

  • @chardonnayexpress
    @chardonnayexpress Рік тому

    Can you use dobutamine for complete heart block?

  • @robertmwangi8046
    @robertmwangi8046 3 роки тому

    Very useful

  • @rhirhi7260
    @rhirhi7260 3 роки тому

    Great video!!! Can you do a video on the following: if a patient is on more than one Blood pressure drip or drip from heart rate how do you know which one to titrate first?

    • @Melanie3581
      @Melanie3581 3 роки тому

      That is putting it altogether and that comes with time and experience with vasoactive drips.

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      I did cover some basic principals of this in the part 2 of the vasopressors video in the ICU drips series. (ua-cam.com/video/mR6EMZYL9UM/v-deo.html)
      That said, there are many factors, as Melanie eluded too, including but not limited to provider preference. I've truly seen it all ways from Sunday, so its almost always the first thing I inquire about with multiple drips. What is THEIR preference.
      Sometimes we shoot to just get one off. Other times, it's titrating multiple together. I wish I had a better answer than that, but it really helps to learn what each does and how they are different from each other and then apply that to what your patient needs or has going on.

  • @latestlatest4760
    @latestlatest4760 3 роки тому +1

    If a septic patient is already on a Norepi and vasopressin drip and he is still having a low BP...would you think that the Dobutamine will be helpful? But how about its vasodilation effect? Thanks

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      Great question. We've seen a lot of benefit in using it with septic patients. It really helps to evaluate their EF/CO to determine who might benefit.
      I wouldn't be too worried about the vasodilatory effect, especially if they are going to be a responder to the inotrope as you will see more benefit to perfusion from increased output than you will from any decreased SVR from dobutamine, typically.

    • @latestlatest4760
      @latestlatest4760 3 роки тому

      @@ICUAdvantage thanks!

  • @AshwoodLy
    @AshwoodLy 3 роки тому +1

    In my hospital, Dopamine needs a CVC line but okay to run through a PIV for 24hrs while waiting for CVC placement. However, it is not clear if Dobutamine needs a CVC access. Do you happen to know anything about whether Dobutamine needs CVC access for more than 24hrs usage?

    • @ICUAdvantage
      @ICUAdvantage  3 роки тому +1

      Great question. We use PIV for Dobutamine. While it is more an inotrope than vasoactive, the isomer does have alpha-1 effects. I think the incidents of major injury from dobutamine extravasation are limited. Dopamine at my facility is more tolerable via PIV vs CVC when compared to other typical vasopressors, but again, for any of them, we will absolutely use a PIV if no other access is present and its needed. Of course quickly obtaining a central afterwords is important.

  • @elcocoreyes
    @elcocoreyes 3 роки тому

    👍👍

  • @bre97bj
    @bre97bj Рік тому

    where do i find the video notes?
    \

    • @ICUAdvantage
      @ICUAdvantage  Рік тому

      Sorry for the confusion and that I missed this comment. YT doesn't make it clear to find. If you go to the main ICU Advantage UA-cam page, then look for the "Community" tab at the top. This is where the member posts are. Look for the most recent post for the link to the notes and the current password (changes each month).

  • @mingwcrystalchan6583
    @mingwcrystalchan6583 3 роки тому

    Why would you choose dobutamine over adrenaline if both have similar effect?

  • @pranaliwaghmare3732
    @pranaliwaghmare3732 3 роки тому

    Video is good but I can't understand due to language barrier please tell in simple English

  • @JaTirk
    @JaTirk 2 роки тому

    Thanks! I have a cardiac meds quiz coming up, and I just found your page. I plan on going into ICU out of nursing school. I cant wait!

    • @ICUAdvantage
      @ICUAdvantage  2 роки тому

      Thank you so much Jacob! Hope the med quiz went well and best of luck in getting to the ICU!