Pharmacologic agents for acute hemodynamic instability

Recent advances in the management of perioperative shock-A systematic review

Steven T. Morozowich, Harish Ramakrishna

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Despite the growing body of evidence evaluating the efficacy of vasoactive agents in the management of hemodynamic instability and circulatory shock, it appears no agent is superior. This is becoming increasingly accepted as current guidelines are moving away from detailed algorithms for the management of shock, and instead succinctly state that vasoactive agents should be individualized and guided by invasive hemodynamic monitoring. This extends to the perioperative period, where vasoactive agent selection and use may still be left to the discretion of the treating physician with a goal-directed approach, consisting of close hemodynamic monitoring and administration of the lowest effective dose to achieve the hemodynamic goals. Successful therapy depends on the ability to rapidly diagnose the etiology of circulatory shock and thoroughly understand its pathophysiology as well as the pharmacology of vasoactive agents. This review focuses on the physiology and resuscitation goals in perioperative shock, as well as the pharmacology and recent advances in vasoactive agent use in its management.

Original languageEnglish (US)
Pages (from-to)543-554
Number of pages12
JournalAnnals of Cardiac Anaesthesia
Volume18
Issue number4
DOIs
StatePublished - Oct 1 2015

Fingerprint

Shock
Hemodynamics
Pharmacology
Perioperative Period
Resuscitation
Guidelines
Physicians
Therapeutics

Keywords

  • Circulatory shock
  • Hemodynamic instability
  • Perioperative period
  • Perioperative shock
  • Vasoactive agent

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Pharmacologic agents for acute hemodynamic instability : Recent advances in the management of perioperative shock-A systematic review. / Morozowich, Steven T.; Ramakrishna, Harish.

In: Annals of Cardiac Anaesthesia, Vol. 18, No. 4, 01.10.2015, p. 543-554.

Research output: Contribution to journalArticle

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