Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA.
Investigational Drug Services, Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA.
J Pharm Pract. 2020 Aug;33(4):523-532. doi: 10.1177/0897190019844124. Epub 2019 May 5.
The objective of this article is to discuss the pharmacology, side effects, and clinical application of vasoactive therapy in the management of adult septic shock.
Sepsis is one of the most common reasons for admission to an intensive care unit with the incidence estimated to be greater than 750 000 cases per year in the United States. Clinicians should understand the basic pharmacology of available vasoactive agents to allow for routine and complex management of septic shock.
While advances in research, identification, and early implementation of best practices for the treatment of sepsis has reduced mortality, rates remain high. Vasopressors and inotropes remain part of the core therapeutic modalities of sepsis management. Norepinephrine is the first-line vasopressor of choice for septic shock, though secondary vasopressors can be used depending on the patient's circumstances.
本文旨在讨论血管活性治疗在成人脓毒性休克管理中的药理学、副作用和临床应用。
脓毒症是重症监护病房（ICU）最常见的入住原因之一，据估计，在美国每年的发病率超过 75 万例。临床医生应了解可用血管活性药物的基本药理学，以便对脓毒性休克进行常规和复杂的管理。
尽管在脓毒症的治疗方面，研究、识别和早期实施最佳实践的进展已经降低了死亡率，但仍居高不下。血管加压药和正性肌力药仍然是脓毒性休克管理的核心治疗方式的一部分。去甲肾上腺素是脓毒性休克的一线血管加压药选择，尽管可以根据患者的情况使用二线血管加压药。
