Journal
PHARMACOTHERAPY
Volume 39, Issue 3, Pages 369-381Publisher
WILEY
DOI: 10.1002/phar.2220
Keywords
sepsis; septic shock; vasoactive agents; norepinephrine; vasopressin; epinephrine; phenylephrine; angiotensin II
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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.
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