Key result
Angiotensin II and vasopressin show promise for refractory vasodilatory shock following first-line fluids and norepinephrine.
Why the study?
Vasodilatory shock often fails to respond to high-dose vasopressors, catecholamines can lose pressor effects, and newer modalities show favorable outcomes.
This review highlights updates in managing vasodilatory shock, focusing on newer modalities like angiotensin and arginine vasopressin as alternatives to catecholamines.
Should not change first-line shock management; leaves open the role of angiotensin II and vasopressin pending prospective trials.
Managing vasodilatory shock remains the most challenging entity for intensivists even today.It is simply because the condition does not respond to high-dose vasopressors and results in high mortality.Currently, catecholamines are the most widely used vasopressors to maintain stable blood pressures in intensive-care settings, but loss of catecholamine-pressor effects is a well-known clinical dilemma.However, studies with newer modalities like angiotensin, arginine vasopressin etc. have pointed favorable outcomes.We briefly discuss the updates in managing vasodilatory shock, with focus on evidence-based recommendations.
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Lahiry et al. (2019) conducted a review in Vasodilatory shock. Fluid therapy and vasopressors was evaluated. Fluid resuscitation and norepinephrine remain first-line therapies for vasodilatory shock, while newer agents like angiotensin II and vasopressin show promise for refractory cases.
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