Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department
Much research, both pathophysiological and clinical, has been produced about septic shock during the last 20 years. Nevertheless, many aspects of treatment are still controversial, among these the approach to the administration of fluids and vasopressors. After the first clinical trial on Early goa...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2023-03-01
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| Series: | Emergency Care Journal |
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| Online Access: | https://www.pagepressjournals.org/index.php/ecj/article/view/10810 |
| _version_ | 1797858190247854080 |
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| author | Daniele Coen |
| author_facet | Daniele Coen |
| author_sort | Daniele Coen |
| collection | DOAJ |
| description |
Much research, both pathophysiological and clinical, has been produced about septic shock during the last 20 years. Nevertheless, many aspects of treatment are still controversial, among these the approach to the administration of fluids and vasopressors. After the first clinical trial on Early goal-directed therapy (EGDT) was published, a liberal approach to the use of fluids and conservative use of vasopressors prevailed, but in recent years a more restrictive use of fluids and an earlier introduction of vasopressors seem to be preferred. Although both treatments are based on sound pathophysiological knowledge, clinical evidence is still inadequate and somehow controversial. In this non-systematic review, recent research on the hemodynamics of septic shock and its treatment with fluids and inotropes is discussed. As a conclusion, general indications are proposed for a practical approach to patients in septic shock.
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| first_indexed | 2024-04-09T21:09:16Z |
| format | Article |
| id | doaj.art-00220bd0a9f04454b573328fd6bd33db |
| institution | Directory Open Access Journal |
| issn | 2282-2054 |
| language | English |
| last_indexed | 2024-04-09T21:09:16Z |
| publishDate | 2023-03-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Emergency Care Journal |
| spelling | doaj.art-00220bd0a9f04454b573328fd6bd33db2023-03-28T22:45:31ZengPAGEPress PublicationsEmergency Care Journal2282-20542023-03-0119110.4081/ecj.2023.10810Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency departmentDaniele Coen0Emergency Department, Grande Ospedale Metropolitano Niguarda, Milan Much research, both pathophysiological and clinical, has been produced about septic shock during the last 20 years. Nevertheless, many aspects of treatment are still controversial, among these the approach to the administration of fluids and vasopressors. After the first clinical trial on Early goal-directed therapy (EGDT) was published, a liberal approach to the use of fluids and conservative use of vasopressors prevailed, but in recent years a more restrictive use of fluids and an earlier introduction of vasopressors seem to be preferred. Although both treatments are based on sound pathophysiological knowledge, clinical evidence is still inadequate and somehow controversial. In this non-systematic review, recent research on the hemodynamics of septic shock and its treatment with fluids and inotropes is discussed. As a conclusion, general indications are proposed for a practical approach to patients in septic shock. https://www.pagepressjournals.org/index.php/ecj/article/view/10810fluid resuscitationvasopressorsseptic shockpreloadstressed volumeemergency department |
| spellingShingle | Daniele Coen Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department Emergency Care Journal fluid resuscitation vasopressors septic shock preload stressed volume emergency department |
| title | Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department |
| title_full | Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department |
| title_fullStr | Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department |
| title_full_unstemmed | Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department |
| title_short | Fluids and vasopressors in septic shock: basic knowledge for a first approach in the emergency department |
| title_sort | fluids and vasopressors in septic shock basic knowledge for a first approach in the emergency department |
| topic | fluid resuscitation vasopressors septic shock preload stressed volume emergency department |
| url | https://www.pagepressjournals.org/index.php/ecj/article/view/10810 |
| work_keys_str_mv | AT danielecoen fluidsandvasopressorsinsepticshockbasicknowledgeforafirstapproachintheemergencydepartment |