WHY I DON'T LIKE PHENYLEPHRINE

WHY I DON'T LIKE PHENYLEPHRINE // On the last CritBits we talked about why norepinephrine is great. But many people like phenylephrine better. In this CritBits I'll talk about why it's not my go to vasopressor. Hint: there's too much alpha.
But there are some cases where it's good to use...watch the video for more on these specific situations.

[@sowhat3430]

Love your way to play out, and your voice is soothe to listen. Video short and sweet

[@CriticalCareNow]

Thank you Justin

[@Laringoskop]

Great video! Also phenylephrine prolonged infusion is more likely to cause limb ischemia, than epi or n.a.

[@CriticalCareNow]

Thanks for commenting

[@tomward876]

I've been using Phenylephrine for decades. It's the most effective decongestant I have found. I went to Walgreens and CVS to buy up what they had on the shelf since it's being removed.

[@CriticalCareNow]

Hmmm….I don’t know how to respond.

[@fallofmanbrand]

Loved It!

[@CriticalCareNow]

Thanks

[@ShadyRamirez-g1s]

Thanks Edwin but it doesn't work good with my methamphetamine and heart irregularities

[@abdulmanafm2208]

Great content.
Please do a critbit on Atrial fibrillation in ICU

[@CriticalCareNow]

Okay!

[@sheikhsadaf]

CriticalCareNow Afib In ER.. requesting a critbits

[@CriticalCareNow]

Okay! Will do

[@sheikhsadaf]

Loved it. Thanks

[@CriticalCareNow]

Thank you

[@kp41221]

I was taught in school, that in addition to increasing afterload, phenylepi tightens up the venous side, increasing return to the heart, improving SV and CO if the patient is preload dependent. Thoughts?

[@CriticalCareNow]

I think all vasopressors do that. That’s why I like norepi...does that too

[@pierrearbulu]

2 things: 1 very nice video 2 where's your giraffe?

[@CriticalCareNow]

1. Thank you for watching 2. I’ll be showing at ResusX! Hope you’re well

[@umeraltaf5192]

If a patient is hypotensive despite fluid resuscitation, levo, epi and vaso let's says because of septic shock, do you then start phenylephrine? I understand it's not a great choice, but are there times when you kind of have to start it unwillingly?
P.S love the crit bits! So helpful.

[@CriticalCareNow]

Yes! I still use but 2nd to last. Only dopamine is worse

[@nicolekupchik5959]

What about starting Giapreza?! Works great in Septic Shock! I would caution about using it as “last ditch effort”, we know how that pans out.

[@sheikhsadaf]

Can nalbuphine for sedation/analgesia? Phenyleph is super short acting and cause bradycardia

[@CriticalCareNow]

I’ve never used. Thanks for your comment