• Shock · Oct 2016

    Vasodilators in Septic Shock Resuscitation: A Clinical Perspective.

    • Thiago Domingos Corrêa, Roberto Rabello Filho, Murillo Santucci Cesar Assunção, Eliézer Silva, and Alexandre Lima.
    • *Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.†Department of Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands.
    • Shock. 2016 Oct 26.

    AbstractMicrocirculatory abnormalities have been shown to be frequent in patients with septic shock despite "normalization" of systemic hemodynamics. Several studies have explored the impact of vasodilator therapy (prostacyclin, inhaled nitric oxide, topic acetylcholine and nitroglycerin) on microcirculation and tissue perfusion, with contradictory findings.In this narrative review, we briefly present the pathophysiological aspects of microcirculatory dysfunction, and depict the evidence supporting the use of vasodilators and other therapeutic interventions (fluid administration, blood transfusion, vasopressors and dobutamine) aiming to improve the microcirculatory flow in septic shock patients.

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