Originally Posted by jetproppilot
If you come off pacing, tho, and it doesn't work, where do you go?
You go back on bypass.
You have no safety net.
That's why I'm suggesting exhausting your pharmacologic armamentarium before pacing.
Because you are leaving yourself a safety net.
If you're able to separate from bypass without pacing,
you've got another weapon in your holster if things go awry.
Being ahead of the game pays dividends.
Use everything you know when doing a difficult case.
I've done the Atropine trick many times, dudes.
I wouldn't suggest it if it didn't work.
Volume coming in, venous line clamped, bradycardia,
A lotta times pacing unneeded.
I don't have time to make a randomized double blinded study.
Why are you giving such a large dose of atropine? That's double the code dose. You ever get a brisk response >100?
Also, you have any thoughts on what you're treating? I'm concerned that acute bradycardia immediately after separation may be from air down the RCA.
I'm all for trying out various techniques to get me to the ICU, but if we have an issue coming off pump, I want to make sure that pacer is working. If it's not, you've got to troubleshoot that, especially if the patient has demonstrated a tendency to brady down. Atropine or not, you gotta get that **** working.
You ever use ephedrine coming off?