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Summary of the Day

Aortic Stenosis: Etiology, Pathophysiology, and Clinical Presentation

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Question of the Day

Which of the following agents would be LEAST effective in the management of refractory hypotension in the brain dead patient undergoing organ donation?

Question of the Day
Which of the following agents would be LEAST effective in the management of refractory hypotension in the brain dead patient undergoing organ donation?
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Explanation

There is sympathetic collapse in the majority of brain dead patients and they often require vasopressor support. Common causes of treatment refractory hypotension including hypovolemia, hypocalcemia, and acidemia must be corrected. Vasopressin can reduce vasopressor requirements as well as treat central diabetes insipidus in the setting of brain death. Adrenal insufficiency due to hypothalamic-pituitary-adrenal dysfunction is treated with corticosteroids (methylprednisolone or hydrocortisone). Finally, thyroid hormone (thyroxine or triiodothyronine) can be useful in decreasing vasopressor requirements and managing circulatory collapse.

OA Series: February 2024

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OA-SPA Pediatric Anesthesia Virtual Grand Rounds

Caudal Epidural Anesthesia in Pediatric Patients

Adam Von Samek, MD, Icahn School of Medicine at Mount Sinai, Max Feinstein, MD, Columbia University