Vasoactive drugs in the intensive care unit
Current Opinion in Critical Care, ISSN: 1070-5295, Vol: 11, Issue: 5, Page: 413-417
2005
- 78Citations
- 170Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations78
- Citation Indexes72
- 72
- CrossRef53
- Clinical Citations3
- PubMed Guidelines3
- Policy Citations3
- Policy Citation3
- Captures170
- Readers170
- 170
Review Description
Purpose of the review: Vasoactive drugs are the mainstay of hemodynamic management of vasodilatory shock when fluids fail to restore tissue perfusion. In this review, studies published during the past year that increase our understanding of the use of vasoactive drugs in the intensive care unit are discussed. Recent findings: In septic shock, there is no benefit in increasing mean arterial pressure from 65 to 85 mmHg. Norepinephrine did not worsen renal function. Epinephrine induced visceral hypoperfusiort and hyperlactatemia, and worsened organ function and survival compared with norepinephrine and vasopressin. There are a number of reports of the safety and efficacy of vasopressin but it is not currently recommended as first line therapy, and if used, should be given as a continuous low dose infusion. Terlipressin is showing promise but decreases cardiac output. Metaraminol is being investigated as an alternative to norepinephrine. Dopamine may improve splanchnic flow mainly by increasing cardiac output. Dobutamine improves oxygen delivery and may improve mesenteric blood flow. Summary: Over the last 40 years, there have been few controlled clinical trials to guide clinicians on the use of vasoactive drugs of treating shock states. It is not known whether the currently favored combination of norepinephrine and dobutamine is superior to traditional therapy with dopamine. Epinephrine is not recommended as the first-line therapy. The role of vasopressin and terlipressin remains unknown. Three large ongoing clinical trials will be completed soon and the results should clarify the role of these various agents. © 2005 Lippincott Williams & Wilkins.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=26944490709&origin=inward; http://dx.doi.org/10.1097/01.ccx.0000176696.70013.da; http://www.ncbi.nlm.nih.gov/pubmed/16175026; http://journals.lww.com/00075198-200510000-00004; https://dx.doi.org/10.1097/01.ccx.0000176696.70013.da; https://journals.lww.com/co-criticalcare/Abstract/2005/10000/Vasoactive_drugs_in_the_intensive_care_unit.4.aspx
Ovid Technologies (Wolters Kluwer Health)
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