Vasopressors and Inotropes explained | Alpha Vs Beta effects | Paramedic

Hi all,

My name is James, I am an advanced life support paramedic. I am currently doing my Masters in medical education. I am passionate about EMS and make these video's purely because I enjoy doing so and in the hopes that you all will enjoy them.


I still find it confusing, which one is which. Alpha or beta. I found making this helpful.
Vasopressors and Inotropes explained in a helpful way.


Research:
https://www.nejm.org/doi/full/10.1056...

Dopamine vs NE: Same death rate, but dopamine had more negative effects.


https://journals.lww.com/jtrauma/Abst...
Prehospital Resuscitation with Phenylephrine in Uncontrolled Hemorrhagic Shock and Brain Injury
Phen vs LR, LR has less secondary effects. (better blood to brain)


http://citeseerx.ist.psu.edu/viewdoc/...
In shock, dopamine does no naturally increase. Adrenaline and NE do.



https://ccforum.biomedcentral.com/art...
CardShock study
cardiogenic shock - adrenaline use is associated with excess organ injury and mortality
adrenaline was independently associated with 90-day mortality in CS


https://www.cochranelibrary.com/cdsr/...
meta analysis of RCT
At present there are no robust and convincing data to support a distinct inotropic or vasodilator drug based therapy as a superior solution to reduce mortality in haemodynamically unstable patients with CS or low cardiac output complicating AMI.

https://academic.oup.com/eurheartj/ar...
Despite the frequent use of catecholamines which are administered in ∼90% of patients in CS,7 there is only limited evidence from randomized trials comparing catecholamines in CS. Furthermore, despite beneficial effects on haemodynamics, there are no randomized data showing a prognostic benefit.

https://www.academia.edu/download/533...
adrenaline in CA, no improvement, only better rosc


http://www.prehospitalpush.com/wp-con...
We found no evidence of substantial differences in total mortality between several vasopressors.
RCT meta analysis


https://www.ncbi.nlm.nih.gov/pmc/arti...
Survival After Shock Requiring High-Dose Vasopressor Therapy more than 1mcg/kg/min (normal 0.01-0.03)
One in six patients with shock survived to 90 days after HDV