title: Vasodilators in Septic Shock Resuscitation: A Clinical Perspective.
abstract: Microcirculatory abnormalities have been shown to be frequent in patients with septic shock despite "normalization" of systemic hemodynamics. Several studies have explored the impact of vasodilator therapy (prostacyclin, inhaled nitric oxide, topic acetylcholine, and nitroglycerin) on microcirculation and tissue perfusion, with contradictory findings.In this narrative review, we briefly present the pathophysiological aspects of microcirculatory dysfunction, and depict the evidence supporting the use of vasodilators and other therapeutic interventions (fluid administration, blood transfusion, vasopressors, and dobutamine) aiming to improve the microcirculatory flow in septic shock patients.
authors: *Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil †Department of Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors: Thiago Domingos
authors: TD
authors: Corrêa
authors: Roberto Rabello
authors: RR
authors: Filho
authors: Murillo Santucci Cesar
authors: MS
authors: Assunção
authors: Eliézer
authors: E
authors: Silva
authors: Alexandre
authors: A
authors: Lima
mesh_terms: D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D012151:Resuscitation / Q000379:methods*; D012772:Shock, Septic / Q000188:drug therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents