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Topic: Vasopressor

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		Vasopressor therapy may be required transiently, even while cardiac filling pressures are not yet adequate, in order to maintain perfusion in the face of life-threatening hypotension.
		Should this occur, the dose of vasopressor should be lowered, or the use of dobutamine considered [78].
		Administration of vasopressors may impair blood flow to the splanchnic system, and this impairment can be manifested by stress ulceration, bowel ileus, and malabsorption [109,110].
	staff.washington.edu /rohrs/practice_parameters_sepsis.htm (16769 words)

	Critical Care \| Full text \| The International Sepsis Forum's controversies in sepsis: my initial vasopressor agent in ...
		Vasopressor agents are often used in patients with septic shock when aggressive fluid resuscitation fails to correct hypotension.
		Recent studies indicate that the fear of deleterious effect was unwarranted and that norepinephrine may have a role as a first-line vasopressor agent in patients with septic shock.
		The cerebral effects of dopamine and norepinephrine were compared in a recent crossover study conducted in 19 patients with severe head trauma requiring vasopressor therapy [3].
	ccforum.com /content/7/1/3 (2033 words)

	Use of Vasopressors in Cardipulmonary Resuscitation
		We are currently conducting a multicentre randomised clinical trial under the aegis of the European Resuscitation Council to study the effects of vasopressin vs. epinephrine in cardiac arrest patients.
		Vasopressin is a promising alternative vasopressor during CPR, in both laboratory and clinical investigations.
		We found that a combination of the vasopressor vasopressin and the vasodilator nitro-glycerine significantly improved endocardial blood flow as well as the endocardial/epicardial blood flow ratio, when compared with vasopressin alone.
	www.euroanesthesia.org /education/rc_vienna/13rc3.HTM (2776 words)

	What are the current recommendations regarding the use of vasopressin in the treatment of shock?
		The rationale for the use of vasopressin is its relative deficiency in circulation and the increased sensitivity to its vasopressor effects seen during septic shock.
		Because vasopressin is a potent vasopressor, infusions of vasopressin in patients with several forms of shock have led to improved organ perfusion, increased mean arterial pressure, improved blood pressure and neurologic function.
		Beale RJ et al reported that in 2003, critical care and infectious disease experts representing eleven international organizations developed guidelines for vasopressor and inotropic support in septic shock under the auspices of the Surviving Sepsis Campaign (an international effort to increase awareness and to improve outcome in severe sepsis).
	www.globalrph.com /vasopressin_shock.htm (1363 words)

	Vasopressors, Inotropes Not Used Consistently in Sepsis
		The selection, use, and monitoring of vasopressor and inotrope therapy for sepsis and septic shock is highly variable.
		Guidelines exist for the hemodynamic management of sepsis and septic shock with inotropes and vasopressors, but not very many clinicians follow them, suggest the results of a survey presented at the Annual Meeting of the Society of Critical Care Medicine.
		Vasopressor and/or inotrope "cocktails" consisted of norepinephrine and vasopressin with and without dopamine in 15.3% and 13.4% of cases, respectively.
	www.pulmonaryreviews.com /apr06/vasopressors.html (479 words)

	Vasopressor Response to Angiotensin II Infusion in Patients With Chronic Heart Failure Receiving {beta}-Blockers -- ... (Site not responding. Last check: 2007-10-10)
		Vasopressor Response to Angiotensin II Infusion in Patients With Chronic Heart Failure Receiving {beta}-Blockers -- Vittorio et al.
		The vasopressor response to Ang II was determined by examining
		Vasopressor response or PD20 of Ang II is shown in ng/kg on x-axis.
	circ.ahajournals.org /cgi/content/full/107/2/290 (2354 words)

	EMedHome.com
		The goal of vasopressor administration is to restore end organ perfusion, particularly to the brain.
		Recommendation on the vasopressor of choice for massive pulmonary embolus is difficult because clinical information is limited to anecdotal or case reports, and experimental data are limited to animal models.
		Vasopressors are used to counteract left ventricular dysfunction and hypotension.
	www.emedhome.com /features_printfriendly.cfm?FID=73 (5082 words)

	Clinical Trial: Dopamine and Norepinephrine in Shock Patients
		Vasopressor agents are commonly used to correct hypotension in patients with acute circulatory failure.
		Indeed, in such cases, vasopressor therapy should anyway be started, either with dopamine or with norepinephrine, and these 2 therapies are currently equally valid 1st choices.
		If this open label vasopressor consisted in dopamine and if this agent cannot be fully weaned after the introduction of the blinded solution, the open label dopamine will be replaced by an open label norepinephrine infusion.
	www.clinicaltrials.gov /ct/show/NCT00314704 (1743 words)

	Tiina Erkinaro. Fetal and placental haemodynamic responses to hypoxaemia, maternal hypotension and vasopressor therapy ...
		Fetal and placental haemodynamic responses to hypoxaemia, maternal hypotension and vasopressor therapy in a chronic sheep model.
		Knowledge of the effects of maternally administered vasopressors on human fetal and placental haemodynamics is sparse and limited to elective Caesarean deliveries in uncomplicated pregnancies.
		In response to acute hypoxaemia, a fetus with normal placental function redistributes its right ventricular cardiac output from the pulmonary to the systemic circulation and is able to increase its combined cardiac output, with a concomitant relative decrease in the net forward flow through the aortic isthmus.
	herkules.oulu.fi /isbn9514281659 (440 words)

	General Guidelines for the Use of Vasopressor and Inotropic Agents (Site not responding. Last check: 2007-10-10)
		Many of these drugs classified as either a vasopressor or inotropic agent have combinations of each of these effects.
		Vasopressors are indicated for a decrease of >30 mmHg from baseline systolic blood pressure, or a mean arterial pressure (MAP) <60 mmHg, with a resultant end-organ dysfunction due to hypoperfusion.
		Generally, septic shock requires approximately 2 liters of saline administration in order for vasopressors to be maximally effective.
	www.med.umich.edu /ccmu/vasopressor.htm (433 words)

	USE OF GLUCOCORTICOIDS IN A BURN PATIENT WITH ADULT RESPIRATORY SYNDROME
		Septic shock is defined as sepsis with hypotension, despite adequate fluid resuscitation, together with the presence of perfusion abnormalities that may include, but are not limited to, lactic acidosis, oliguria, or an acute alteration in mental status.
		Patients who are on inotropic or vasopressor agents may not be hypotensive at the moment when perfusion abnormalities are measured.' Septic shock occurs in 20-40% of septic patients, with a mortality rate of 40-90%.
		The patient we present did not have haemodynamic monitoring during this phase, but his dependence on vasopressor agents allows us to suppose with some degree of certainty that the patient persisted with low vascular resistance probably as a consequence of an inflammatory response.
	www.medbc.com /annals/review/vol_14/num_1/text/vol14n1p07.htm (3303 words)

	Vasopressors and regional blockade
		Generally speaking, ephedrine appears to remain the vasopressor of choice to treat hypotension in the obstetric population (Chapter 6).
		Vasopressor therapy for hypotension due to epidural anesthesia for Cesarean section.
		Ephedrine remains the vasopressor of choice for treatment of hypotension during ritodrine infusion and epidural anesthesia.
	www.manbit.com /oa/c79.htm (753 words)

	Adrenomedullin in the rostral ventrolateral medulla increases arterial pressure and heart rate: roles of glutamate and ... (Site not responding. Last check: 2007-10-10)
		Vasopressor effects of ADM in the RVLM are abolished by ADM
		Vasopressor effects of ADM in the RVLM are abolished by MK-801 and CNQX.
		Vasopressor effects of ADM in the RVLM are abolished by 7-NiNa and methylene blue.
	ajpregu.physiology.org /cgi/content/full/287/4/R729 (3956 words)

	Clinical Practice Guidelines (Site not responding. Last check: 2007-10-10)
		Other vasopressor combinations may also be used transiently in the face of life threatening hypotension.
		Mean arterial pressure is the endpoint of vasopressor therapy.
		If septic shock is suspected, it is appropriate to start broad-spectrum antibiotics until culture results and specificities are back, at which time antibiotic coverage should be appropriate for the organisms identified.
	www.uphs.upenn.edu /surgery/trauma/Links/CPGresus.html (649 words)

	UNM Cardiopulmonary Resuscitation Committee (Site not responding. Last check: 2007-10-10)
		Primarily stimulates B-1 receptors in the heart and is used for inotropic support with mild chronotropic effect.
		Vasopressor, IV infusion: Usual dose in code situation is 5-20mcg/kg/min.
		Adrenergic agent of choice for cardiac arrest, vasopressor used in Pulsless VT/VF, Asystole and PEA: 1 mg IV every 3-5 min.
	hsc.unm.edu /emermed/cpr/AdultCart/Adult_Drugs_list.shtml (616 words)

	How do I treat this patient with sepsis?
		It remains the agent of choice when patients are in-extremis – such as in anaphylactic shock or cardiac arrest.
		Otherwise, we now reserve the use of epinephrine as an add on vasopressor (with norepinephrine) or when the cause of hypotension is unclear (it is a most reliable “backs to the wall” pressor).
		Epinephrine has potent beta-1, beta-2 and alpha-1 adrenergic activity, though the increase in mean arterial pressure in sepsis is mainly from an increase in cardiac output (stroke volume).
	www.ccmtutorials.com /infection/sepsisrx/page10.htm (215 words)

	Amazon.com: vasopressor (Site not responding. Last check: 2007-10-10)
		TX: Use of vasopressors result in loss of limbs: unavoidable accident not result of malpractice.(Luck v.
		Prehospital management of cardiac arrest: How useful are vasopressor and antiarrhythmic drugs?: An article from: Prehospital Emergency Care by Marvin A Wayne, Edward M Racht, Richard V Aghababian, and Peter J Kudenchuk (Mar 31, 2002)
		Prostaglandin modulation of pressure and vasopressor induced changes in GFR, vascular resistance, and natriuresis in isolated perfused rat kidney by Gilbert Wayne Gleim (Unknown Binding - 1984)
	www.amazon.com /s?ie=UTF8&keywords=vasopressor&tag=icongroupinterna&index=blended&link_code=qs&page=1 (935 words)

	The Lasker Foundation \| Former Award Winners, Clinical Medical Research
		In 1896, two physiologists at the Karolinska Institute, Robert Tigerstedt and Per Bergmann, injected extracts of kidneys into the bloodstream of rabbits, and they made a dramatic observation: the extracts produced an acute elevation in the blood pressure.
		Goldblatt proposed that the decrease in blood supply causes the kidney to release a vasopressor substance.
		Angiotensin II is the most potent natural vasopressor made by the body.
	www.laskerfoundation.org /awards/library/1999remarksgsclin2.shtml (2072 words)

	Cariporide Potentiates the Effects of Epinephrine and Vasopressin by Nonvascular Mechanisms During Closed-Chest ... (Site not responding. Last check: 2007-10-10)
		The number of rats that met the criteria for administration of the vasopressor agent is shown in each bar.
		The vasopressor dose was given as a bolus at 2 min of perfusion.
		Either cariporide (open symbols) or 0.9% NaCl (closed symbols) was infused throughout the low-flow perfusion state in both the epinephrine (n = 8) and vasopressin (n = 8) series.
	www.chestjournal.org /cgi/content/full/127/4/1327 (3909 words)

	Ann Intern Med -- Minneci et al. 141 (1): 47 Figure 4
		The relative benefit (95% CI) and the hazard ratio (with 95% CI) of shock reversal for the sepsis trials published after 1997 are presented.
		Of note, in 3 of the 4 studies, the discontinuation of vasopressor therapy with steroid treatment statistically significantly improved.
		In the fourth trial, the effect of steroid therapy on vasopressor discontinuation was similar to the effect in the other trials (I
	www.annals.org /cgi/content-nw/full/141/1/47/F4 (79 words)

	Clinical Trial: COMT-Polymorphism in Cardiac Surgery
		We hypothesize that there is a significant increase in the duration of vasopressor support in patients with LL COMT compared to patients with HH COMT genotype.
		We hypothesize that differences similar to that seen in the duration of vasopressor support will be seen in the severity of renal dysfunction (increase of serum creatinine), duration of ICU stay and duration of hospital stay.
		The duration and dose of postoperative vasopressor support as well as stay in ICU and stay in hospital will be documented.
	www.clinicaltrials.gov /ct/show/NCT00334009 (1298 words)

	Reduced Dietary Potassium Reversibly Enhances Vasopressor Response to Stress in African Americans -- Sudhir et al. 29 ... (Site not responding. Last check: 2007-10-10)
		Abstract Acute vasopressor responses to stress are adrenergically
		the attenuation of vasopressor responses to stressors observed
		The vasopressor response to cold is mediated in large part by
	hyper.ahajournals.org /cgi/content/full/29/5/1083 (4895 words)

	Vasopressors for shock
		It is unclear if there is a vasopressor of choice, either for the treatment of particular forms of shock or for the treatment of shock in general.
		We included randomized controlled trials comparing various vasopressors, vasopressors with placebo or vasopressors with intravenous fluids for the treatment of any kind of circulatory failure (shock).
		We were unable to determine whether a particular vasopressor is superior to other agents in the treatment of states of shock.
	www.cochrane.org /reviews/en/ab003709.html (552 words)

	Evidence Favoring the Use of an {alpha}2-Selective Vasopressor Agent for Cardiopulmonary Resuscitation -- Pellis et al. ... (Site not responding. Last check: 2007-10-10)
		Evidence Favoring the Use of an {alpha}2-Selective Vasopressor Agent for Cardiopulmonary Resuscitation -- Pellis et al.
		The rationale for the administration of vasopressor agents during
		The rationale for the vasopressor agent is to increase CPPs
	circ.ahajournals.org /cgi/content/full/108/21/2716 (2774 words)

	Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia-induced ... (Site not responding. Last check: 2007-10-10)
		amine, is probably the vasopressor of choice in obstetric anaesthesia.
		The usual approach to the use of vasopressors in this clinical
		vasopressor administration or a larger dose may have reduced
	bja.oxfordjournals.org /cgi/content/full/86/3/372 (2406 words)

	Hemodynamic Support in Fluid-refractory Pediatric Septic Shock -- Ceneviva et al. 102 (2): e19 -- Pediatrics (Site not responding. Last check: 2007-10-10)
		Assess outcome in children treated with inotrope, vasopressor, and/or vasodilator therapy for reversal of fluid-refractory
		Inotropic therapy (with or without a vasodilator) was used to reverse shock in 58% of the children (group I), vasopressor
		decreased vascular tone were treated with vasopressors, and CI was maintained endogenously or with inotropes.
	pediatrics.aappublications.org /cgi/content/full/102/2/e19 (3977 words)

	Adrenal Insufficiency in High-Risk Surgical ICU Patients -- Rivers et al. 119 (3): 889 -- Chest
		vasopressor dependent if these agents were required to maintain
		vasopressor agents and corresponding dose ranges were norepinephrine
		doses of vasopressor therapy with its possible negative consequences.
	www.chestjournal.org /cgi/content/full/119/3/889 (3754 words)

	Effects of Continuous Vasopressin Infusion in Patients with Septic Shock -- Obritsch et al. 38 (7): 1117 -- The Annals ...
		Hemodynamic and vasopressor data were collected for the 8-hour
		be initiated relative to catecholamine vasopressors, the optimal
		to 1 or 2 catecholamine vasopressors is inadequate or as a method
	www.theannals.com /cgi/content/full/38/7/1117 (2932 words)

	Characterization of Murine Vasopressor and Vasodepressor Prostaglandin E2 Receptors -- Zhang et al. 35 (5): 1129 -- ... (Site not responding. Last check: 2007-10-10)
		Characterization of Murine Vasopressor and Vasodepressor Prostaglandin E2 Receptors -- Zhang et al.
		A, Pretreatment with SC46275 (10 µg/kg) blocked the vasopressor effect of sulprostone (10 µg/kg) in EP
		of the vasopressor E-prostanoid response, a remaining vasodepressor
	hyper.ahajournals.org /cgi/content/full/35/5/1129 (3114 words)

	Effects of Norepinephrine on the Renal Vasculature in Normal and Endotoxemic Dogs -- BELLOMO et al. 159 (4): 1186 -- ... (Site not responding. Last check: 2007-10-10)
		Septic shock is often complicated by systemic hypotension despite normal or increased cardiac output.
		advisability of sustained vasopressor infusions in the hemodynamically
		The effects of norepinephrine infusion on RBF may not be unique to this vasopressor, but representative of the group of potent
	ajrccm.atsjournals.org /cgi/content/full/159/4/1186 (4707 words)

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