Inotrope and vasopressor therapy of septic shock.
When fluid administration fails to restore an adequate arterial pressure and organ perfusion in patients with septic shock, therapy with vasoactive agents should be initiated. The ultimate goals of such therapy in shock are to restore effective tissue perfusion and to normalize cellular metabolism. The efficacy of hemodynamic therapy in sepsis should be assessed by monitoring a combination of clinical and hemodynamic parameters. Although specific end points for therapy are debatable, and therapies will inevitably evolve as new information becomes available, the idea that clinicians should define specific goals and end points, titrate therapies to those end points, and evaluate the results of their interventions on an ongoing basis remains a fundamental principle.
Hollenberg
Steven M
SM
Divisions of Cardiovascular Disease and Critical Care Medicine, Cooper University Hospital, Camden, NJ 08103, USA. Hollenberg-Steven@cooperhealth.edu
D018663:Adrenergic Agents / Q000627:therapeutic use; D000316:Adrenergic alpha-Agonists / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D002302:Cardiac Output / Q000502:physiology; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004298:Dopamine / Q000008:administration & dosage / Q000627:therapeutic use; D004837:Epinephrine / Q000494:pharmacology / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D010656:Phenylephrine / Q000494:pharmacology / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D012151:Resuscitation; D012772:Shock, Septic / Q000188:drug therapy* / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use
D018663:Adrenergic Agents; D000316:Adrenergic alpha-Agonists; D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D010656:Phenylephrine; D004298:Dopamine; D004837:Epinephrine