1. Exploring Horizons in the Treatment of Vasoplegia in Shock Syndromes.
- Author
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dos Santos Soares, Ricardo Oliveira and Barbosa Evora, Paulo Roberto
- Subjects
- *
VASOCONSTRICTORS , *ADRENOCORTICAL hormones , *CRITICALLY ill , *CATECHOLAMINES , *PATIENTS , *MICROCIRCULATION , *RENIN-angiotensin system , *SEPSIS , *MIDODRINE , *TOXIC shock syndrome , *METHYLENE blue ,VASCULAR disease diagnosis - Abstract
Vasoplegic endothelial dysfunction stands out as one of the most prominent shock syndromes in the intensive care unit, and despite continual therapeutic advances, it is still associated with poor prognosis in critical cases. This scenario is compatible with a significant inflammatory disturbance, with a propensity for increased vascular permeability and deterioration of endothelial response to modulators: a microcirculation disaster. The hemodynamic support's backbone is based primarily on fluid replacement and the use of vasopressor and inotropic agents in nonresponsive patients, aiming to establish a mean arterial pressure of at least 65 mmHg and therefore promote adequate tissue reperfusion. The present study's primary target is to discuss the combination of 3 concepts as a useful strategy for improving results against the high rates of mortality in critically ill patients. These 3 concepts are (1) the use of "broad-spectrum vasopressors," (2) vasopressorsparing strategy, and (3) microcirculation protection. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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