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Vasopressors in Sepsis.

Kristin P Colling¹, Kaysie L Banton¹, Greg J Beilman¹

¹Department of Surgery, Division of Critical Care and Acute Care Surgery, University of Minnesota , Minneapolis Minnesota.

Surgical Infections

|January 17, 2018

Summary

Early sepsis recognition and treatment are crucial. Norepinephrine is the preferred first-line vasopressor for septic shock, with other agents used as second-line or in specific patient populations.

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Area of Science:

Critical Care Medicine
Pharmacology
Infectious Diseases

Background:

Sepsis represents 10% of ICU admissions, incurring substantial healthcare costs.
Despite improved critical care, sepsis mortality remains high at 20%-30%.

Purpose of the Study:

To review current literature on vasopressor use in septic shock.
To guide optimal vasopressor selection and management in sepsis.

Main Methods:

Literature review of English-language publications.

Main Results:

Norepinephrine is the first-line vasopressor for septic shock, linked to lower mortality and fewer adverse effects.
Dopamine carries a higher risk of tachydysrhythmias; epinephrine and vasopressin are suitable second-line agents.
Inotropes may be beneficial for patients with cardiac dysfunction.

Conclusions:

Sepsis management requires prompt identification, antibiotics, fluid resuscitation, and vasopressors for shock.
Further research is needed on optimal timing for adding second vasopressor agents and individualized combinations.

Keywords:

infection sepsis shock vasoactive agents

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