Journal of Acute Care

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VOLUME 1 , ISSUE 3 ( September-December, 2022 ) > List of Articles


Squeeze the Pipes in Septic Shock

Keywords : Intravenous fluid, Septic shock, Vasopressors

Citation Information : Squeeze the Pipes in Septic Shock. 2022; 1 (3):141-142.

DOI: 10.5005/jp-journals-10089-0051

License: CC BY-NC 4.0

Published Online: 03-05-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Rationale for fluid resuscitation is to increase mean systemic filling pressure, venous return, and cardiac output by increasing circulatory stressed volume. However, several conditions must be fulfilled to achieve desirable outcomes from fluid resuscitation. Vasopressors are also important components of resuscitation in septic shock (SS) and can potentially supplement the beneficial effects of fluid. However, the potential benefits of vasopressors must be weighed against several harms associated with vasopressors. Risks associated with vasopressors are more pronounced with underfilling of circulation and in higher doses. Current physiological and clinical evidence support intravenous fluids as the first-line resuscitation agent in SS with vasopressor infusion as a supplement to the same.

  1. Vincent JL, Nielsen ND, Shapiro NI, et al. Mean arterial pressure and mortality in patients with distributive shock: a retrospective analysis of the MIMIC-III database. Ann Intensive Care 2018;8(1):107. DOI: 10.1186/s13613-018-0448-9
  2. Bai X, Yu W, Ji W, et al. Early versus delayed administration of norepinephrine in patients with septic shock. Crit Care 2014;18(5):532. DOI: 10.1186/s13054-014-0532-y
  3. Ospina-Tascón GA, Hernandez G, Bakker J. Should we start vasopressors very early in septic shock? J Thorac Dis 2020;12(7):3893–3896. DOI: 10.21037/jtd.2020.02.21
  4. Permpikul C, Tongyoo S, Viarasilpa T, et al. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER). A randomized trial. Am J Respir Crit Care Med 2019;199(9):1097–1105. DOI: 10.1164/rccm.201806-1034OC
  5. Morimatsu H, Singh K, Uchino S, et al. Early and exclusive use of norepinephrine in septic shock. Resuscitation 2004;62(2):249–254. DOI: 10.1016/j.resuscitation.2004.03.016
  6. Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med 2021;49(11):e1063– e1143. DOI: 10.1097/CCM.0000000000005337
  7. Scheeren TWL, Bakker J, De Backer D, et al. Current use of vasopressors in septic shock. Ann Intensive Care 2019;9(1):20. DOI: 10.1186/s13613-019-0498-7
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