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Feb 16, 2021 · Patients with septic shock require vasopressor to maintain a mean arterial pressure (MAP) of 65 millimeters mercury (mm Hg) or greater and serum lactate level greater than 2 millimoles per liter (>18 milligrams per deciliter) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. 6.
- Muhammad Azfar Ruslan, Kamarul Aryffin Baharuddin, Norhayati Mohd Noor, Mohd Boniami Yazid, Abu Yazi...
- 10.5811/westjem.2020.10.47825
- 2021
- West J Emerg Med. 2021 Mar; 22(2): 196-203.
Norepinephrine is recommended as a first-line agent in the treatment of septic shock and we suggest against dopamine use. Both observational studies 77–79 and a multicenter RCT 80 suggested norepinephrine to be superior to dopamine in terms of 28 day mortality, likely driven by an increase in arrhythmias due to dopamine.
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Today, norepinephrine remains the mainstay vasopressor treatment for septic shock . Whereas the lifesaving properties of norepinephrine are undisputed, growing experimental evidence suggests that excessive dosing or duration of norepinephrine infusion could adversely affect patient outcomes because of its multiple “collateral” effects on ...
- Fabrice Uhel, Tom van der Poll
- 2020
suggested (usually when norepinephrine dose is 0.25-0.5 μg/kg/min.) o For patients on norepinephrine and vasopressin with inadequate MAP, the addition of epinephrine is suggested. o Use of terlipressin is not suggested. • For patients with septic shock and cardiac dysfunction who have persistent hypoperfusion
Nov 27, 2019 · Early norepinephrine use in septic shock. As vascular tone depression is a hallmark of septic shock, administration of norepinephrine is logical in this setting. In this article, we provide and develop the following arguments for an early use of norepinephrine—the recommended first-line vasopressor—in septic shock: (I) prevention of ...
- Olfa Hamzaoui, Rui Shi
- 2020
Jan 1, 2020 · Sepsis is a life-threatening organ dysfunction that results from the body’s response to infection. It requires prompt recognition, appropriate antibiotics, careful hemodynamic support, and control of the source of infection. With the trend in management moving away from protocolized care in favor of appropriate usual care, an understanding of sepsis physiology and best practice guidelines is ...
Abstract. Purpose of review. Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension due to depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension when ...
