Peer-reviewed veterinary case report
Controversies regarding choice of vasopressor therapy for management of septic shock in animals.
- Journal:
- Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
- Year:
- 2015
- Authors:
- Silverstein, Deborah C & Beer, Kari A Santoro
- Affiliation:
- From the Department of Clinical Studies · United States
Plain-English summary
This study looked at the use of certain medications called vasopressors, which help raise blood pressure in pets experiencing septic shock, a serious condition caused by infection. The researchers found that while the specific vasopressor chosen may not significantly change the outcome, different medications can lead to various side effects, like a fast heartbeat. Norepinephrine is recommended as the first choice for raising blood pressure, and if needed, epinephrine can be added. However, there isn't enough solid evidence yet to determine the best treatment for septic shock in pets, so more research is needed to create clear guidelines. Overall, the treatment of low blood pressure in pets with septic shock remains complex and requires further study.
Abstract
OBJECTIVE: To review and appraise common vasopressor drugs used to treat septic shock-induced hypotension in volume replete animals. DATA SOURCES: Human and animal publications were searched using PubMed without time limits and the following keywords were used: "vasopressor," "septic shock," "norepinephrine," "dopamine," "epinephrine," and "vasopressin." HUMAN DATA SYNTHESIS: The choice of vasopressor drug is unlikely to have a marked impact on outcome, but the incidence of adverse events (eg, tachycardia) varies greatly between the various treatment options. In agreement with the 2012 Cochrane Database consensus, norepinephrine is the first-choice vasopressor to maintain a mean arterial pressure ≥65 mm Hg. If an additional agent is required, epinephrine should be administered. Low-dose vasopressin can be added to norepinephrine to either increase the arterial blood pressure to the target goal value or decrease the norepinephrine dose, but should not be used as the initial vasopressor. Dopamine is not recommended except in highly selected circumstances. VETERINARY DATA SYNTHESIS: There is insufficient evidence to make definitive conclusions regarding the treatment of naturally occurring septic shock, but clinical studies are underway to provide further data. CONCLUSIONS: The treatment of hypotension in people or animals with septic shock is challenging and vasopressor therapy is associated with a variety of adverse effects. Further research is warranted in dogs and cats to establish evidence-based guidelines.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/25655726/