Using of Oral Midodrine in Weaning of Intravenous Vasopressors in Patients with Septic Shock admitted to ICU

Abstract

S eptic shock is the most severe form of sepsis, in which profound underlying abnormalities in circulatory and cellular/metabolic parameters lead to substantially increased mortality. Diagnosis of septic shock is based on presence of certain symptoms, signs & there is also many Biomarkers which are essential for Diagnosis and Prognosis of Sepsis patients like CRP, Prolactin & BNP. While guidelines provide an attractive approach, there remain many challenges for the management of patients with septic shock. These include issues with hemodynamic targets and therapies, as well as challenges in applying the recommended therapies. To ensure better outcome for patients, Treatment of septic shock mainly depend on early Initiation of Therapy in the Emergency Department, proper choice of Antimicrobial Drugs & hemodynamic support for the patients including Oxygenation, anticoagulation therapy, proper Fluid Therapy & Vasopressors. Midodrine is an oral alpha-agonist approved for orthostatic hypotension. The use of midodrine as a vasopressor sparing agent has steadily increased in the ICU despite limited evidence for its safety in that setting. Midodrine is an orally administered drug which can be used safely for geriatric but not for children.