Septic shock causes unpredictable cardiovascular responses through adrenoreceptor-mediated changes in cardiac function and vascular responsiveness. The use of norepinephrine should be regarded as neurohormonal augmentation therapy to defend decompensating haemodynamic function rather than as a rescue therapy to treat shock. Recent trials represent a perceptible change in clinical practice to preferentially use norepinephrine early in resuscitation to defend the mean arterial pressure and to use norepinephrine as a neurohormone rather than as a vasopressor.
AD - Division of Critical Care and Trauma, The George Institute for Global Health, Level 7, 341 George Street, Sydney 2000, Australia. j.myburgh@unsw.edu.au AN - 20860853 BT - Critical Care ET - 2010/09/24 LA - eng M1 - 5 N1 - Myburgh, JohnCommentEnglandCritical care (London, England)Crit Care. 2010;14(5):196. Epub 2010 Sep 20. N2 -Septic shock causes unpredictable cardiovascular responses through adrenoreceptor-mediated changes in cardiac function and vascular responsiveness. The use of norepinephrine should be regarded as neurohormonal augmentation therapy to defend decompensating haemodynamic function rather than as a rescue therapy to treat shock. Recent trials represent a perceptible change in clinical practice to preferentially use norepinephrine early in resuscitation to defend the mean arterial pressure and to use norepinephrine as a neurohormone rather than as a vasopressor.
PY - 2010 SN - 1466-609X (Electronic)1364-8535 (Linking) EP - 196 T2 - Critical Care TI - Norepinephrine: more of a neurohormone than a vasopressor VL - 14 ER -