Haider Warraich
speaker
683 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2021
Haider Warraich’s voice in public audio — every appearance, attributed to the second.
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you know, has an advanced illness and is critically ill and without any sort of advanced therapy options.
And so under most circumstances, I think that they are an oxymoron.
I think a lot of times we start inotropes and without really demonstrating
Is it helping someone feel better?
Is it helping someone do more?
Are the drawbacks of the therapy more than what the benefits are?
In fact, I think many folks who work with me on the inpatient side, I wrote this review with a really stellar team, which was led by a fellow at Northwestern, Sarah Choozie, on palliative inotropes for JAMA cardiology.
I often...
Every single time I'm on service, I share that piece because this comes up all the time.
And I will often try and wean this therapy because I do not believe that most people actually feel any different.
And I think language really matters.
I wish more cardiologists call these things palliative inotropes.
What I hear a lot is this is rocket fuel.
This is going
juice up your heart.
It's going to help your heart beat stronger without listing out that, well, yes, but at a price of potentially increased mortality, at least according to the randomized trials.
tried to find the data and there are small registries of inotropes, but really we don't have a very clear sense of what's really going on.
We have seen in heart failure in general, things that we know from prior randomized trial data have not been very effective, such as, for example, PA catheters.
We know from the largest clinical trials that they don't improve outcomes.
We know their use is going up.
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