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Use of vasopressor agents in critically ill patients

Kellum, JA and Pinsky, MR (2002) Use of vasopressor agents in critically ill patients. Current Opinion in Critical Care, 8 (3). 236 - 241. ISSN 1070-5295

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Distributive shock is a common problem in intensive care. Systemic hypotension is a medical emergency and will cause end-organ injury if not reversed. There are relatively few medications available to treat distributive shock. Catecholamines are most widely used for this indication and work by stimulating α- and/or β-adrenergic receptors. Vasopressin and corticosteroids may have a role in reversing refractory shock and work primary through nonadrenergic mechanisms. Shock is difficult to define using hemodynamic criteria, because the same hemodynamic values can be normal in one patient, yet represent shock in another. Thus, the appropriate therapeutic endpoints for vasopressor therapy are not uniform for all patients. Similarly, the available evidence comparing vasopressor agents in terms of safety and efficacy is limited. When used at doses necessary to reverse distributive shock, less potent vasoconstrictors (eg, dopamine) do not appear to be safer than more potent ones (eg, norepinephrine) and do not appear to be as effective. © 2002 Lippincott Williams & Wilkins, Inc.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Kellum, JAkellum@pitt.eduKELLUM0000-0003-1995-2653
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 January 2002
Date Type: Publication
Journal or Publication Title: Current Opinion in Critical Care
Volume: 8
Number: 3
Page Range: 236 - 241
DOI or Unique Handle: 10.1097/00075198-200206000-00007
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 1070-5295
Article Type: Review
PubMed ID: 12386503
Date Deposited: 14 Jul 2012 21:15
Last Modified: 30 Jan 2020 16:55


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