Keller Marius, Magunia Harry
Anasthesiol Intensivmed Notfallmed Schmerzther. 2021 Jun;56(6):400-413. doi: 10.1055/a-1214-4472. Epub 2021 Jun 29.
Vasopressors are widely used in anaesthesiology and critical care medicine, to treat harmless (e.g. anaesthesia-induced hypotension) as well as life-threatening conditions (e.g. septic shock). Some clinically used vasopressors resemble endogenous substances - such as norepinephrine - while others have been artificially synthesized (e.g. phenylephrine). Most of the substances used in different clinical scenarios have various effects except for vasoconstriction alone. Therefore, a thorough understanding of the pharmacology and clinical profile of every single substance is of highest importance prior to practical usage. Furthermore, the fundamentals of vascular physiology and vasotonic regulation are mandatory to safely provide vasopressor-based therapies. This article covers the essentials of physiology and pharmacology of vasopressors, and the clinical settings they are used in (e.g. septic shock, vasoplegic shock after cardiac surgery, trauma-induced hypotension).
血管升压药在麻醉学和重症医学中广泛应用，用于治疗无害情况（如麻醉引起的低血压）以及危及生命的状况（如感染性休克）。一些临床使用的血管升压药类似于内源性物质——如去甲肾上腺素——而其他一些则是人工合成的（如去氧肾上腺素）。除了单纯的血管收缩作用外，不同临床场景中使用的大多数物质还有各种其他作用。因此，在实际使用前，全面了解每种物质的药理学和临床特征至关重要。此外，血管生理学和血管张力调节的基础知识对于安全实施基于血管升压药的治疗是必不可少的。本文涵盖了血管升压药的生理学和药理学要点，以及它们所应用的临床场景（如感染性休克、心脏手术后的血管麻痹性休克、创伤性低血压）。
