Norepinephrine: more of a neurohormone than a vasopressor.
Septic shock causes unpredictable cardiovascular responses through adrenoreceptor-mediated changes in cardiac function and vascular responsiveness. The use of norepinephrine should be regarded as neurohormonal augmentation therapy to defend decompensating haemodynamic function rather than as a rescue therapy to treat shock. Recent trials represent a perceptible change in clinical practice to preferentially use norepinephrine early in resuscitation to defend the mean arterial pressure and to use norepinephrine as a neurohormone rather than as a vasopressor.
Myburgh
John
J
Division of Critical Care and Trauma, The George Institute for Global Health, Level 7, 341 George Street, Sydney 2000, Australia. j.myburgh@unsw.edu.au
D000818:Animals; D006801:Humans; D018377:Neurotransmitter Agents / Q000378:metabolism / Q000627:therapeutic use*; D009638:Norepinephrine / Q000378:metabolism / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012151:Resuscitation / Q000379:methods; D012772:Shock, Septic / Q000188:drug therapy / Q000378:metabolism; D014662:Vasoconstrictor Agents / Q000378:metabolism / Q000627:therapeutic use*
D018377:Neurotransmitter Agents; D014662:Vasoconstrictor Agents; D009638:Norepinephrine