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首页> 外文期刊>Current opinion in anaesthesiology >Vasopressor use in septic shock: an update.
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Vasopressor use in septic shock: an update.

机译：在败血性休克中使用Vasopressor：一个更新。

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PURPOSE OF REVIEW: This article reviews new findings on the use of vasopressor agents in septic shock. RECENT FINDINGS: Several recent large randomized clinical trials have compared vasopressor agents in patients with septic shock. Briefly, the survival of patients treated with norepinephrine alone or a combination of norepinephrine and dobutamine did not significantly differ from that of patients treated with epinephrine. In observational studies, dopamine use was associated with poor outcome. The results of a clinical trial comparing dopamine and norepinephrine as a first-line agent in septic shock are pending. The addition of low-dose vasopressin to norepinephrine did not significantly improve the survival of patients with septic shock. A positive effect on survival was observed in a predetermined (norepinephrine dose <15 microg/kg/min) subgroup of patients with moderate shock. There is no large randomized clinical trial on the use of terlipressin. In contrast, nitric oxide inhibitors were associated with increased mortality in patients with septic shock. SUMMARY: The use of norepinephrine or epinephrine can be left to the discretion of the treating physician. Low-dose vasopressin administration remains an option for catecholamine-refractory septic shock. The potential benefit of early use in combination with a moderate dose of norepinephrine remains to be determined.
机译：审查目的：本文概述了在脓毒性休克中使用升压药的新发现。最近的发现：最近的一些大型随机临床试验已经比较了败血性休克患者的血管加压药。简而言之，单独使用去甲肾上腺素或联合去甲肾上腺素和多巴酚丁胺治疗的患者的存活率与接受肾上腺素治疗的患者的存活率没有显着差异。在观察性研究中，使用多巴胺与不良预后相关。比较多巴胺和去甲肾上腺素作为败血性休克的一线药物的临床试验结果尚待研究。在去甲肾上腺素中加入小剂量加压素并不能显着改善败血性休克患者的生存。在预定的（去甲肾上腺素剂量<15微克/千克/分钟）中度休克患者亚组中观察到了对生存的积极影响。没有关于使用特利加压素的大型随机临床试验。相反，一氧化氮抑制剂与败血性休克患者死亡率增加相关。总结：去甲肾上腺素或肾上腺素的使用可以由主治医师自行决定。小剂量加压素仍然是儿茶酚胺难治性败血症性休克的一种选择。早期使用与中剂量去甲肾上腺素联合使用的潜在益处尚待确定。

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