vasopressor therapy
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2021 ◽  
Author(s):  
Sabri Soussi ◽  
Dallas Duncan ◽  
Bernard Cholley ◽  
Stuart McCluskey
Keyword(s):  

2021 ◽  
Author(s):  
Alexandre Joosten ◽  
Philippe Van der Linden ◽  
Brenton Alexander ◽  
Joseph Rinehart ◽  
Jacques Duranteau
Keyword(s):  

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Catalina Paraschiv ◽  
Livia F Trasca ◽  
Octavian Enciu ◽  
Serban M Balanescu ◽  
Adrian Miron

ABSTRACT Takotsubo syndrome is a rare cause of systolic dysfunction and can be found as a clinical manifestation of pheochromocytoma. We present a case of rapid onset of systolic dysfunction with cardiogenic shock, which developed after the surgical excision of an adrenal gland tumor in a 60-year-old male. Coronary angiography excluded coronary artery disease. The echocardiography and ventriculography images suggested Takotsubo cardiomyopathy pattern. Following 2 weeks of inotropic and vasopressor therapy, the left ventricular function gradually improved, until complete resolution.


Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1559
Author(s):  
Liana Valeanu ◽  
Serban-Ion Bubenek-Turconi ◽  
Carmen Ginghina ◽  
Cosmin Balan

Circulatory failure in sepsis is common and places a considerable burden on healthcare systems. It is associated with an increased likelihood of mortality, and timely recognition is a prerequisite to ensure optimum results. While there is consensus that aggressive source control, adequate antimicrobial therapy and hemodynamic management constitute crucial determinants of outcome, discussion remains about the best way to achieve each of these core principles. Sound cardiovascular support rests on tailored fluid resuscitation and vasopressor therapy. To this end, an overarching framework to improve cardiovascular dynamics has been a recurring theme in modern critical care. The object of this review is to examine the nature of one such framework that acknowledges the growing importance of adaptive hemodynamic support combining macro- and microhemodynamic variables to produce adequate tissue perfusion.


2021 ◽  
Vol 10 (14) ◽  
pp. 3164
Author(s):  
Pierre-Grégoire Guinot ◽  
Audrey Martin ◽  
Vivien Berthoud ◽  
Pierre Voizeux ◽  
Loic Bartamian ◽  
...  

Despite the abundant literature on vasopressor therapy, few studies have focused on vasopressor-sparing strategies in patients with shock. We performed a scoping-review of the published studies evaluating vasopressor-sparing strategies by analyzing the results from randomized controlled trials conducted in patients with shock, with a focus on vasopressor doses and/or duration reduction. We analyzed 143 studies, mainly performed in septic shock. Our analysis demonstrated that several pharmacological and non-pharmacological strategies are associated with a decrease in the duration of vasopressor therapy. These strategies are as follows: implementing a weaning strategy, vasopressin use, systemic glucocorticoid administration, beta-blockers, and normothermia. On the contrary, early goal directed therapies, including fluid therapy, oral vasopressors, vitamin C, and renal replacement therapy, are not associated with an increase in vasopressor-free days. Based on these results, we proposed an evidence-based vasopressor management strategy.


2021 ◽  
Vol 18 (3) ◽  
pp. 79-86
Author(s):  
L. L. Plotkin

Refractory shock is the shock that does not respond to vasopressor therapy. Refractory shock with a short-term mortality rate of more than 50% is diagnosed in 6-7% of critically ill patients. There is an objective need to Investigate methods of intensive therapy for refractory septic shock.The objective of the study: to analyze literature data on the intensive care of refractory septic shock.Results. The second part of the article analyzes 37 studies, both Russian and foreign ones devoted to the intensive care of refractory shock. At present, based on the analysis of the publication, it is impossible to draw reasonable conclusions about the advantage of one or another method of intensive therapy for refractory shock (veno-venous hemofiltration, the use of angiotensin II and vasopressin, as well as methylene blue, vitamin B12, ECMO) over basic therapy.


2021 ◽  
Vol 18 (1) ◽  
pp. 57-64
Author(s):  
A. A. Kochkin ◽  
V. V. Likhvantsev ◽  
К. К. Kadantseva

The objective: to investigate the efficacy and safety of terlipressin when it is used as an additional vasopressor in septic shock.Subjects: A single-center, observational, retrospective-prospective study of the efficacy and safety of combined therapy of septic shock with norepinephrine and terlipressin versus monotherapy with norepinephrine was conducted.Results. The use of terlipressin made it possible to reduce the average daily need for noradrenaline in patients with septic shock from 0.68 μg · kg-1 · min-1 in the control group to 0.55 μg · kg-1 · min-1 in the study group (p = 0.015) and reduce the duration of vasopressor support from 8 days [6.0-11.0] to 6 days [5.0-8.0] in the study group (p = 0.023). The use of terlipressin did not reduce the need for mechanical ventilation, but it did reduce the duration of ventilation.  The number of days free from mechanical ventilation in patients in the control group was 6.0 [1.0-18.0], in the study group - 16.0 [2.0-22.0], (p = 0.039).Conclusion. The use of terlipressin as a supplement to norepinephrine is an effective and relatively safe treatment for hypotension in refractory septic shock. 


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ishaq Lat ◽  
◽  
Craig M. Coopersmith ◽  
Daniel De Backer ◽  
Craig M. Coopersmith

Abstract Objective To expand upon the priorities of fluid resuscitation and vasopressor therapy research priorities identified by a group of experts assigned by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Data Sources Original paper and literature search. Study Selection Several members of the original task force with expertise specific to the area of fluid resuscitation and vasopressor therapy. Data Extraction None. Data Synthesis None. Conclusion In the second of a series of manuscripts subsequent to the original paper, members with expertise in the subjects expound upon the three identified priorities related to fluid resuscitation and vasopressor therapies. This analysis summarizes what is known and what were identified as ongoing and future research.


2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Raghav Chandra ◽  
Samuel Gold ◽  
Casey Kohler ◽  
Jason Valladares ◽  
Sara A. Hennessy ◽  
...  

Toxic shock syndrome is a serious complication of Streptococcus pyogenes or Staphylococcus aureus infections associated with very high morbidity and mortality. Postoperative toxic shock syndrome is an extremely rare phenomenon which manifests as fevers, diffuse rash, septic shock, and death. We present the first reported case of toxic shock syndrome associated with a surgical site infection from a decompressive neurectomy for refractory migraines in a 41-year-old female as well as the first use of angiotensin-2 vasopressor therapy to treat persistent septic shock from toxic shock syndrome refractory to conventional therapies.


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