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Vasopressors and Inotropes in Sepsis
Leeanne Stratton1, David A Berlin2, John E Arbo3
1Division of Emergency Medicine, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.
Emergency Medicine Clinics of North America
|December 3, 2016
Summary
Vasopressors and inotropes like norepinephrine and dobutamine aid shock management. Emergency providers must understand their complex effects and continually reassess patients for effective treatment.
Area of Science:
- Critical care medicine
- Pharmacology
Background:
- Shock states, particularly sepsis-associated hypotension, necessitate prompt and effective hemodynamic support.
- Vasopressors and inotropes are critical pharmacologic agents used to manage these complex conditions.
Purpose of the Study:
- To review the roles of vasopressors and inotropes in shock states.
- To emphasize the importance of understanding their complex physiological effects and clinical trial data for emergency providers.
Main Methods:
- Review of current clinical guidelines and relevant physiological principles.
- Analysis of clinical trial data pertaining to vasopressor and inotrope use in shock.
Main Results:
- Norepinephrine is the recommended first-line vasopressor for sepsis-induced hypotension.
- Dobutamine is the preferred first-line inotrope in sepsis, especially with myocardial dysfunction or persistent hypoperfusion.
Conclusions:
- Vasopressor and inotrope therapy requires careful consideration of individual patient physiology and response.
- Continuous reassessment of patient status is essential to optimize treatment efficacy and outcomes in shock management.
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