Abstract
The choice of inotropic agent, particularly in catecholamine-resistant septic shock, remains an area of debate. Here we discuss a recent trial examining the use of vasopressin in a carefully controlled trial setting. Yet more data on the use of drotrecogin alfa (activated) in septic shock are described, as are novel but as yet experimental approaches to the treatment of sepsis. Finally, it is important not to forget to read the latest surviving sepsis guidelines.
Highlights
“Man is a creature composed of countless millions of cells: a microbe is composed of only one, yet throughout the ages the two have been in ceaseless conflict”
One of the basic tenets of treating septic shock is the provision of cardiovascular support through the use of catecholamines, there is much interest in other agents as addressed in the study by Russell and colleagues in The New England Journal of Medicine [2]
The authors themselves do concede that the baseline mean arterial pressures observed (72 to 73 mmHg) were somewhat higher than expected and the trial probably reflects the use of vasopressin as a catecholamine-sparing drug rather than being an evaluation of vasopressin as an agent in shock unresponsive to catecholamines
Summary
“Man is a creature composed of countless millions of cells: a microbe is composed of only one, yet throughout the ages the two have been in ceaseless conflict”. One of the basic tenets of treating septic shock is the provision of cardiovascular support through the use of catecholamines, there is much interest in other agents as addressed in the study by Russell and colleagues in The New England Journal of Medicine [2].
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