Year : 2017 | Volume
: 33 | Issue : 1 | Page : 3--8
Vasopressors: Do they have any role in hemorrhagic shock?
Babita Gupta1, Neha Garg2, Rashmi Ramachandran2
1 JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
2 Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
The priority in the management of patients with traumatic hemorrhagic shock is to control the bleeding with simultaneous volume resuscitation to maintain adequate tissue perfusion. Fluid replacement remains the mainstay of initial resuscitation in hemorrhagic shock. Traditionally, vasopressors are contraindicated in the early management of hemorrhagic shock due to their deleterious consequences, although vasopressors may have a role in resuscitation when vasoplegic shock ensues and blood pressure cannot be maintained by fluids alone. Use of vasopressors is not recommended according to the Advanced Trauma Life SupportR management principles. The role of vasopressors remains controversial with no clear guidelines on the timing, type, and dose of these drugs in hemorrhagic shock. Among vasopressors, norepinephrine and vasopressin have been used in the majority of the trials, although not many studies compare the effect of these two on long-term survival in trauma patients. This article reviews the pathophysiology of hemorrhagic shock, adverse effects of fluid resuscitation, and the various experimental and clinical studies on the use of vasopressors in the early phase of resuscitation in hemorrhagic shock.
JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi - 110 029
|How to cite this article:|
Gupta B, Garg N, Ramachandran R. Vasopressors: Do they have any role in hemorrhagic shock?.J Anaesthesiol Clin Pharmacol 2017;33:3-8
|How to cite this URL:|
Gupta B, Garg N, Ramachandran R. Vasopressors: Do they have any role in hemorrhagic shock?. J Anaesthesiol Clin Pharmacol [serial online] 2017 [cited 2017 May 29 ];33:3-8
Available from: http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=1;spage=3;epage=8;aulast=Gupta;type=0