title: Inotropes and vasopressors: more than haemodynamics!
abstract: Circulatory shock is characterized by arterial hypotension requiring fluid resuscitation combined with inotropes and/or vasopressors to correct the otherwise life-threatening impairment of oxygen supply to peripheral tissues. Catecholamines represent the current therapeutic choice, but this standard is only based on empirical clinical experience. Although there is evidence that some catecholamines may be better than others, it is a matter of debate which one may be the most effective and/or the safest for the different situations. In their review in this issue of the British Journal of Pharmacology, Bangash et al. provide an overview of the pharmacology as well as the available clinical data on the therapeutic use of endogenous catecholamines, their synthetic derivatives and a range of other agents (vasopressin and its analogues, PDE inhibitors and levosimendan). The authors point out that, despite well-established receptor pharmacology, the clinical effects of these treatments are poorly understood. Hence, further investigations are essential to determine which catecholamine, or, in a broader sense, which alternative vasopressor and/or inotrope is the most appropriate for a particular clinical condition.
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum, Ulm, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bracht
authors.forename: Enrico
authors.initials: E
authors.lastname: Calzia
authors.forename: Michael
authors.initials: M
authors.lastname: Georgieff
authors.forename: Joel
authors.initials: J
authors.lastname: Singer
authors.forename: Peter
authors.initials: P
authors.lastname: Radermacher
authors.forename: James A
authors.initials: JA
authors.lastname: Russell
mesh_terms: D000818:Animals; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D006801:Humans; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents
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