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Timing of Vasoactive Agents and Corticosteroid Initiation in Septic Shock by Mahmoud A. Ammar; Abdalla A. Ammar; Patrick M. Wieruszewski; Brittany D. Bissell; Micah T. Long; Lauren Albert; Ashish K. Khanna; Gretchen L. Sacha is a Medicine article available to read on EtoBox.

What is Timing of Vasoactive Agents and Corticosteroid Initiation in Septic Shock about?

Septic shock remains a health care concern associated with significant morbidity and mortality. The Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock recommend early fluid resuscitation and antimicrobials. Beyond initial management, the guidelines do not provide clear recommendations on appropriate time to initiate vasoactive therapies and corticosteroids in patients who develop shock. This review summarizes the literature regarding time of initiation of these interventions. Clinical data regarding time of initiation of these therapies in relation to shock onset, sequence of treatments with regard to each other, and clinical markers evaluated to guide initiation are summarized. Early-high vasopressor initiation within first 6 h of shock onset is associated with lower mortality. Following norepinephrine initiation, the exact dose and timing of escalation to adjunctive vasopressor agents are not well elucidated in the literature. However, recent data indicate that timing may be an important factor in initiating vasopressors and adjunctive therapies, such as corticosteroids. Norepinephrine-equivalent dose and lactate concentration can aid in determining wh

Who reads Timing of Vasoactive Agents and Corticosteroid Initiation in Septic Shock?

Author

Mahmoud A. Ammar; Abdalla A. Ammar; Patrick M. Wieruszewski; Brittany D. Bissell; Micah T. Long; Lauren Albert; Ashish K. Khanna; Gretchen L. Sacha

Publisher

Springer Science and Business Media LLC

Published

2022

Language

EN

Field

Medicine (Health Sciences)