Shock and Hemodynamics in the CCU with Dr. Brown

Dr. Lorrel Brown covers the basics of shock including how to recognize cardiac shock from history, physical exam and invasive monitoring. She discusses physiology and interpretation of pulmonary artery catheterization and then covers choice of vasopressors for therapy.
Dr. Brown is an Assistant Professor at the University of Louisville and is the Associate Director of the Cardiovascular Medicine fellowship. Her medical training was completed at Johns Hopkins University. Her areas of interest in cardiac critical care, post-graduate medical education, and in-hospital cardiac arrest.
Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.
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[@prettygirl1024]

I just learned more in an hour with this video than I have in 6 months in the CCU! It finally makes sense!

[@UofLIM]

We are so happy this lecture worked for you! Check out our website for other lectures you might be interested in! www.louisvillelectures.org/test-imls-home-page

[@MBBSZaraHutKay]

Love ... No words to express my Thanks ... Best One

[@RichardSparks]

Dimes, nickels, quarters!! This helped me so much!

[@alexanderrotolo1566]

Love it! Great prep for CVICU rotation.

[@apophisxo4480]

Great lecture!!! Thank you :)

[@joanhmoore]

Thank you for making this fun!, I understand hemo much better. Thank you!!!!

[@UofLIM]

That's great news!

[@safaaaz5512]

excellent lecture!

[@oOoironhideoOo]

Best. Teacher. Ever.

[@UofLIM]

+oOoironhideoOo We think she is pretty awesome as well!

[@aliiraq9655]

Beautiful lecture .. thank you ..

[@kishornellikonda6062]

Very useful lectures. Thanks a lot 👍

[@burninsage7126]

Thank you! What a high quality lecture.

[@shan5582]

great lecture!

[@user-si5sy9rc9c]

This is great! Thanks a lot!!

[@mortonmachir9059]

Great as always Dr. Brown. If you get wind of this you should drop a Billy Madison reference "stop looking at me swan" when talking about swanz ganz catheters. It would be supper funny... keep up these videos they are great!

[@whynotjustmyusername]

5:42 I'd suggest an alteration to that shock list. Here you have mixed pathophysiological and aetiological types of shock. Pathophysiological types describe how exactly the dysfunction of circulation and perfusion is happening, it is purely fluid mechanic question. Of those there are four: -hypovolaemic -distributive -cardiogenic -obstructive In other words, this is how "the pump, the tank and the pipes" can go wrong. Shock is rarely a matter of just one pathopyhsiological aspect. The aetiological classification describes how you get to those states, among others, there are: -septic (causing a mix of hypovolaemic (through capillary leak) and distributive (through vasoplegia) shock) -anaphylactic (causing a mix of hypovolaemic and distributive shock, similarly to septic shock) -neurogenic (causing a mix of distributive and cardiogenic shock) -haemorrhagic (causing hypovolaemic shock) And exactly because these types of shock have different pathophysiological aspects, they should not go with the items of the first list.

[@susanchristineknisely3546]

When I started in the ICU EVERY PATIENT had a Swan. I think patients had faster outcomes with Swans. Great video.

[@EyeWatchU2B]

Great interactive lecture! Really liked the "name that shock" activity!

[@jefferyjulio4915]

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[@mohammadmaximilian3077]

@Jeffery Julio instablaster :)

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[@jefferyjulio4915]

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[@mohammadmaximilian3077]

@Jeffery Julio You are welcome =)

[@bomhayhay]

thanks

[@DroptineTrans]

Cool video, Just subscribed!

[@JM-nh8yp]

Good video. I do disagree with her illustration of preload. She says at 27:30 that a hose barely turned on is low preload and on high is high preload. But the valve on the hose controls pressure, not the preload of volume. The city water tank being filled provides the preload. If the tank is empty, you can open the valve all you want and you wont get the preload.

[@elizabethr3746]

Really awesome lecture!! I just wish there was video with it

[@drnitupandeyvlogs793]

awesome!!!!!!!!!

[@darshanru1]

Nice lecture. But, if this is from 2015, why is it, that you're still quoting the American-European consensus definition for ARDS? The Berlin definition has kicked out the PCWP

[@andysok06]

love the physio explanations of this video. makes so much sense. thank you. oh, and the dimes, nickels, quarters!! :)

[@hk6474]

32:39 Should the arrow for MvO2 in the Hypovolemic shock row be pointing down rather than up due to decreased flow rate and normal organ oxygenation ability

[@mohakgpt]

Yes MVO2 decreases in hypovolemic I observed the same thing

[@A.--.]

Body primarily preserves MAP, pH and Osmolarity beacuse it can only sense pressure (vascular baroreceptors) or pH (cns chemoreceptors) or Osmolar pressure (cns osmoreceptors). These 3 constitution the circulatory sensors of the body. The circulatory actors include vagal tone, sympathetic drive, ADH, ACTH. These sensors & actors basically keep the circulation flowing enough to deliver adequate nutrients and remove adequate toxins.

[@medobullah]

can i download it so it can be easier to watch offline

[@justlovely5761]

amazing and i need to find out who Nelson is lol dude answering all the questions! lol #tutormoi

[@Dogdoo2121]

Cardiovascular Critical Care Core Curriculum

[@ayeshaa44]

wow

[@maheshbborhade]

What is Nelson now ? I bet he must be either cardiologist or intesivist.

[@billa4166]

I think I'm in love....

[@theywalkinguptoyouand4060]

Candy? Ooh someone's been watching grey's anatomy.