A global perspective on vasoactive agents in shock.

{"article_title":"A global perspective on vasoactive agents in shock.","author":"Annane D, Ouanes-Besbes L, de Backer D, DU B, Gordon AC, Hern\ufffdndez G, Olsen KM, Osborn TM, Peake S, Russell JA, Cavazzoni SZ","journal_title":"Intensive care medicine","issn":"1432-1238","isbn":"","publication_date":"2018 Jun","volume":"44","issue":"6","first_page":"833","page_count":"","accession_number":"29868972","doi":"10.1007\/s00134-018-5242-5","publisher":"Springer Verlag","doctype":"Journal Article","subjects":"Shock drug therapy; Vasoconstrictor Agents therapeutic use; Cardiotonic Agents; Dobutamine therapeutic use; Humans; Intensive Care Units; Norepinephrine therapeutic use; Shock, Septic","interest_area":["Emergency Medicine"," Surgery"],"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.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=29868972&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Annane D, Ouanes-Besbes L, de Backer D, DU B, Gordon AC, Hern\u00e1ndez G, Olsen KM, Osborn TM, Peake S, Russell JA, Cavazzoni SZ","Journal_Info":"Publisher: Springer Verlag Country of Publication: United States NLM ID: 7704851 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1238 (Electronic) Linking ISSN: 03424642 NLM ISO Abbreviation: Intensive Care Med Subsets: MEDLINE","Publication_Type":"Journal Article; Review","Published_Date":"2018-06-01","Source":"Intensive care medicine [Intensive Care Med] 2018 Jun; Vol. 44 (6), pp. 833-846. Date of Electronic Publication: 2018 Jun 04.","Languages":"English","Electronic_ISSN":"1432-1238","MeSH_Terms":"Shock*\/drug therapy , Vasoconstrictor Agents*\/therapeutic use, Cardiotonic Agents ; Dobutamine\/therapeutic use ; Humans ; Intensive Care Units ; Norepinephrine\/therapeutic use ; Shock, Septic","Subjects":"Cardiotonic Agents, Dobutamine therapeutic use, Humans, Intensive Care Units, Norepinephrine therapeutic use, Shock, Septic, Shock drug therapy, Vasoconstrictor Agents therapeutic use","Title_Abbreviations":"Intensive care medicine","Volume":"44"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"29868972","RelevancyScore":"821","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"821.206726074219"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=29868972&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=29868972&authtype=shib&custid=ns346513&group=main&profile=eds"}