Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 4/2009

01-08-2009 | Commentary

Challenging the rationale of routine vasopressor therapy for management of hypotension

Authors: Max Harry Weil, Wanchun Tang

Published in: Critical Care | Issue 4/2009

Login to get access

Abstract

There is persuasive evidence, including the present report by Dubin and colleagues, of a dissociation between increases in arterial pressure produced by vasopressor agents and improvement in microvascular perfusion and delivery of vital substrates. Especially in settings of septic shock, the current routine administration of adrenergic vasopressor therapy therefore may fail to reverse the primary defect.
Literature
1.
Dubin A, Pozo MO, Casabella CA, Pálizas F Jr, Murias G, Moseinco MC, Kanoore Edul VS, Pálizas F, Estenssoro E, Ince C: Increasing arterial blood pressure with norepinephrine does not improve microcirculatory blood flow: a prospective study. Crit Care 2009, 13: R92. 10.1186/cc7922PubMedCentralCrossRefPubMed
2.
DeBacker D, Creter J, Prewer JC, Dubois MJ, Vincent JL: Microvascular blood flow is altered in patients with sepsis. Am J Resp Crit Care Med 2002, 166: 98-104. 10.1164/rccm.200109-016OCCrossRef
3.
Jin X, Weil MH, Sun S: Decreases in organ blood flows associated with increases in sublingual PCO 2 during hemorrhagic shock. J Appl Physiol 1998, 85: 2360-2364.PubMed
4.
Ristagno G, Sun S, Tang W, Castillo C, Weil MH: Effects of epinephrine and vasopressin on cerebral microcirculatory flows during and after cardiopulmonary resuscitation. Crit Care Med 2007, 35: 2145-2149. 10.1097/01.CCM.0000280427.76175.D2CrossRefPubMed
5.
Vadakan VV: The asphyxiating and exsanguinating death of President George Washington. Permanente J 2004, 8: 76-79.
Metadata
Title
Challenging the rationale of routine vasopressor therapy for management of hypotension
Authors
Max Harry Weil
Wanchun Tang
Publication date
01-08-2009
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2009
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7976

Other articles of this Issue 4/2009

Critical Care 4/2009 Go to the issue

Commentary

Intensive care unit acquired muscle weakness: when should we consider rehabilitation?

Commentary

The riddle of hyperlactatemia

Research

Phenotype changes and impaired function of dendritic cell subsets in patients with sepsis: a prospective observational analysis

Research

Comparison of three methods of extravascular lung water volume measurement in patients after cardiac surgery

Letter

Procalcitonin to guide duration of antibiotic therapy in intensive care patients: some research questions

Commentary

B-type natriuretic levels in critically ill patients: critically misleading?