Current concepts on hemodynamic support and therapy in septic shock

• Main Authors: Leonardo Lima Rocha, Camila Menezes Souza Pessoa, Thiago Domingos Corrêa, Adriano José Pereira, Murillo Santucci Cesar de Assunção, Eliézer Silva
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Anestesiologia 2015-10-01
• Series: Revista Brasileira de Anestesiologia
• Subjects: Choque séptico; Hemodinâmica; Reposição volêmica; Fluidoterapia; Agentes vasoconstritores
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942015000500395&lng=en&tlng=en

ABSTRACTSevere sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary. This article is a literature review of the available evidence on the initial hemodynamic support of the septic shock patients presenting to the emergency room or to the intensive care unit and the main interventions available to reach those targets, focusing on fluid and vasopressor therapy, blood transfusion and inotrope administration.