A global perspective on vasoactive agents in shock

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Title: A global perspective on vasoactive agents in shock
Authors: Annane, D
Ouanes-Besbes, L
De Backer, D
Du, B
Gordon, AC
Hernandez, G
Olsen, K
Osborn, T
Peake, S
Russell, JA
Zanotti Cavazzoni, S
Item Type: Journal Article
Abstract: Purpose: We set out to summarize the current knowledge on vasoactive drugs and their use in the management of shock to inform physicians’ practices. Methods: This is a narrative review by a multidisciplinary, multinational—from six continents—panel of experts including physicians, a pharmacist, trialists, and scientists. Results and conclusions: Vasoactive drugs are an essential part of shock management. Catecholamines are the most commonly used vasoactive agents in the intensive care unit, and among them norepinephrine is the first-line therapy in most clinical conditions. Inotropes are indicated when myocardial function is depressed and dobutamine remains the first-line therapy. Vasoactive drugs have a narrow therapeutic spectrum and expose the patients to potentially lethal complications. Thus, these agents require precise therapeutic targets, close monitoring with titration to the minimal efficacious dose and should be weaned as promptly as possible. Moreover, the use of vasoactive drugs in shock requires an individualized approach. Vasopressin and possibly angiotensin II may be useful owing to their norepinephrine-sparing effects.
Issue Date: 4-Jun-2018
Date of Acceptance: 21-May-2018
URI: http://hdl.handle.net/10044/1/60055
DOI: https://doi.org/10.1007/s00134-018-5242-5
ISSN: 0342-4642
Publisher: Springer
Start Page: 833
End Page: 846
Journal / Book Title: Intensive Care Medicine
Volume: 44
Issue: 6
Copyright Statement: © Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018. The final publication is available at Springer via https://link.springer.com/article/10.1007/s00134-018-5242-5.
Sponsor/Funder: National Institute for Health Research
National Institute for Health Research
Funder's Grant Number: NIHR/CS/009/007
NIHR Fellowship
Keywords: Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
General & Internal Medicine
Shock
Cardiovascular system
Adrenergic agonists
Clinical trials
Practice guidelines
CARDIAC-SURGERY PATIENTS
MEAN ARTERIAL-PRESSURE
LOW-DOSE VASOPRESSIN
SEPTIC SHOCK
CRITICALLY-ILL
SUBLINGUAL MICROCIRCULATION
HOSPITALIZED-PATIENTS
TISSUE OXYGENATION
CARDIOGENIC-SHOCK
VASOPLEGIC SHOCK
Adrenergic agonists
Cardiovascular system
Clinical trials
Practice guidelines
Shock
Cardiotonic Agents
Dobutamine
Humans
Intensive Care Units
Norepinephrine
Shock
Shock, Septic
Vasoconstrictor Agents
Humans
Shock, Septic
Shock
Norepinephrine
Dobutamine
Cardiotonic Agents
Vasoconstrictor Agents
Intensive Care Units
Emergency & Critical Care Medicine
1103 Clinical Sciences
1117 Public Health and Health Services
Publication Status: Published
Online Publication Date: 2018-06-04
Appears in Collections:Division of Surgery
Faculty of Medicine



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