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Shock and Vasopressors: State-of-the-Art Update

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Adult Critical Care Medicine

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Abstract

Shock is present when decreased tissue perfusion results in inadequate blood supply to end organs. Treatment for this state depends on the etiology of shock. Vasopressors are often essential therapy in the setting of distributive shock (decreased systemic vascular resistance) to maintain an appropriate mean arterial pressure (MAP). In septic shock (most common form of distributive shock), norepinephrine is recommended as the first-line vasopressor. When additional vasopressor support is needed, epinephrine and/or low-dose vasopressin may be added. Phenylephrine and dopamine are niche vasopressors to be used in limited situations. A MAP goal of ≥65 mmHg is recommended for the typical patient. Delivery of vasopressors may be safe for a limited time via peripheral IV access. Arterial blood pressure monitoring is recommended over noninvasive monitors when sustained vasopressors are required.

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Authors and Affiliations

  1. Critical Care Medicine, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA

    Michael Kouch & R. Phillip Dellinger

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  1. Michael Kouch
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  2. R. Phillip Dellinger
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Correspondence to R. Phillip Dellinger .

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  1. Newark, NJ, USA

    Jennifer A. LaRosa

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Kouch, M., Dellinger, R.P. (2019). Shock and Vasopressors: State-of-the-Art Update. In: LaRosa, J. (eds) Adult Critical Care Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-94424-1_11

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  • DOI: https://doi.org/10.1007/978-3-319-94424-1_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-94423-4

  • Online ISBN: 978-3-319-94424-1

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