Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio.
Department of Pharmacy, Shirley Ryan Ability Lab, Chicago, Illinois.
Pharmacotherapy. 2019 Mar;39(3):369-381. doi: 10.1002/phar.2220. Epub 2019 Feb 7.
Septic shock is a life-threatening disorder associated with high mortality rates requiring rapid identification and intervention. Vasoactive agents are often required to maintain goal hemodynamics and preserve tissue perfusion. However, guidance regarding the proper administration of adjunct agents for the management of septic shock is limited in patients who are refractory to norepinephrine. This review summarizes vasopressor agents and describes the nuanced application of these agents in patients with septic shock, specifically focusing on clinical scenarios with limited guidance including patients who are nonresponsive to first-line agents and individuals with mixed shock states, tachyarrhythmias, obesity, valvular abnormalities, or other comorbid conditions.
感染性休克是一种危及生命的疾病，死亡率高，需要快速识别和干预。通常需要使用血管活性药物来维持目标血流动力学并维持组织灌注。然而，对于去甲肾上腺素抵抗的患者，关于辅助药物管理感染性休克的正确给药的指导是有限的。本综述总结了血管加压药，并描述了这些药物在感染性休克患者中的应用，特别是重点关注指导有限的临床情况，包括对一线药物无反应的患者和存在混合性休克状态、心动过速性心律失常、肥胖症、瓣膜异常或其他合并症的个体。
