Critical Care PRN Focus Session — Don't Go Breaking My Heart: Pharmacologic Management of Mixed Shock and Stress-Induced Atrial Fibrillation in Non-cardiac Surgery ICU Patients

Critically ill patients frequently develop complex cardiovascular complications that require pharmacists to apply advanced pharmacotherapy principles in dynamic, high-risk settings. This 2-part continuing education activity will focus on cardiac considerations in ICU patients, emphasizing the identification and management of mixed shock states and stress-induced atrial fibrillation in non-cardiac surgery populations. In part 1, participants will examine key pathophysiologic mechanisms and objective clinical data used to differentiate overlapping shock phenotypes and will apply this information to develop patient-specific pharmacologic treatment plans, including the selection and optimization of vasopressors, inotropes, and adjunctive therapies. Part 2 will address the management of stress-induced atrial fibrillation in critically ill patients, with a focus on pharmacologic strategies for acute rate and rhythm control, thoughtful vasopressor selection, and the controversial role of anticoagulation in critical illness/ stress-induced atrial fibrillation in ICU patients using a risk-based framework. Through case-based discussion and practical application, learners will enhance their ability to assess benefit–risk tradeoffs, anticipate medication-related complications, and collaborate effectively within the interprofessional ICU team to optimize hemodynamic stability and patient outcomes.