The Role of Vasopressors and Inotropes In Septic Shock

Abstract

Sepsis is a clinical syndrome characterized by systemic inflammation and widespread tissue injury due to infection. There is a continuum of illness severity ranging from sepsis to severe sepsis and septic shock. When infection is absent, the clinical syndrome is termed systemic inflammatory response syndrome (SIRS). Current theories about the onset and progression of sepsis focus on dysregulation of the inflammatory response, including the possibility that a massive and uncontrolled release of proinflammatory mediators initiates a chain of events that lead to widespread tissue injury. This response can lead to multiple organ dysfunction syndrome (MODS), which is the cause of the high mortality in these patients. The incidence of sepsis varies among the different racial and ethnic groups, but appears to be highest among African- American males. Studies of the incidence of severe sepsis showed that incidence increased by approximately 13% each year with mortality rates ranging from 15% to 30% and more than 60% in septic shock. Hemodynamic monitoring is a cornerstone in the care of hemodynamically unstable septic patient. Timely and adequate correction of instability and tissue hypoperfusion is essential