Early recognition and rapid treatment initiation for any types of shock.
Prognosis
Higher than 50% mortality rate within a month[1][dubious – discuss]
Vasodilatory shock, vasogenic shock, or vasoplegic shock is a medical emergency belonging to shock along with cardiogenic shock, septic shock, allergen-induced shock and hypovolemic shock. When the blood vessels suddenly relax, it results in vasodilation. In vasodilatory shock, the blood vessels are too relaxed leading to extreme vasodilation and blood pressure drops and blood flow becomes very low. Without enough blood pressure, blood and oxygen will not be pushed to reach the body's organs. If vasodilatory shock lasts more than a few minutes, the lack of oxygen starts to damage the body's organs.[2] Vasodilatory shock like other types of shock should be treated quickly, otherwise it can cause permanent organ damage or death as a result of multiple organ dysfunction.[3][4][5][6]
Treatment typically involves uses of vasopressor, inotropes, fluid boluses, and introduction of resuscitation.[4] In case vasodilatory shock fails to respond to high doses of vasopressors (defined as ≥ 0.5 mg/kg/min norepinephrine-equivalent dose[7]), meaning it's vasopressor-resistant and advances to being called refractory vasodilatory shock or simply refractory shock.[4][8] Adjunctive therapies include angiotensin II, hydrocortisone, thiamine, catecholamines, ascorbic acid and combinations of thereof.[4][9][10]
^Cite error: The named reference Auchet Regnier Girerd Levy 2017 p. was invoked but never defined (see the help page).
^Vincent, Jean-Louis; De Backer, Daniel (2013-10-31). Finfer, Simon R.; Vincent, Jean-Louis (eds.). "Circulatory Shock". The New England Journal of Medicine. 369 (18): 1726–1734. doi:10.1056/nejmra1208943. ISSN 0028-4793. PMID 24171518. S2CID 6900105.
^Cite error: The named reference Shock was invoked but never defined (see the help page).
^Cite error: The named reference Gkisioti Mentzelopoulos 2011 pp. 1–6 was invoked but never defined (see the help page).
^Lambden, Simon; Creagh-Brown, Ben C.; Hunt, Julie; Summers, Charlotte; Forni, Lui G. (2018-07-06). "Definitions and pathophysiology of vasoplegic shock". Critical Care. 22 (1): 174. doi:10.1186/s13054-018-2102-1. ISSN 1364-8535. PMC 6035427. PMID 29980217.
^Bassi, Estevão; Park, Marcelo; Azevedo, Luciano Cesar Pontes (2013). "Therapeutic Strategies for High-Dose Vasopressor-Dependent Shock". Critical Care Research and Practice. 2013: 1–10. doi:10.1155/2013/654708. ISSN 2090-1305. PMC 3787628. PMID 24151551.
^Masarwa, Reem; Paret, Gideon; Perlman, Amichai; Reif, Shimon; Raccah, Bruria Hirsh; Matok, Ilan (2017-01-05). "Role of vasopressin and terlipressin in refractory shock compared to conventional therapy in the neonatal and pediatric population: a systematic review, meta-analysis, and trial sequential analysis". Critical Care. 21 (1): 1. doi:10.1186/s13054-016-1589-6. ISSN 1364-8535. PMC 5217634. PMID 28057037.
^Khanna, Ashish; English, Shane W.; Wang, Xueyuan S.; Ham, Kealy; Tumlin, James; Szerlip, Harold; Busse, Laurence W.; Altaweel, Laith; Albertson, Timothy E.; Mackey, Caleb; McCurdy, Michael T.; Boldt, David W.; Chock, Stefan; Young, Paul J.; Krell, Kenneth; Wunderink, Richard G.; Ostermann, Marlies; Murugan, Raghavan; Gong, Michelle N.; Panwar, Rakshit; Hästbacka, Johanna; Favory, Raphael; Venkatesh, Balasubramanian; Thompson, B. Taylor; Bellomo, Rinaldo; Jensen, Jeffrey; Kroll, Stew; Chawla, Lakhmir S.; Tidmarsh, George F.; Deane, Adam M. (2017-08-03). "Angiotensin II for the Treatment of Vasodilatory Shock" (PDF). The New England Journal of Medicine. 377 (5): 419–430. doi:10.1056/nejmoa1704154. ISSN 0028-4793. PMID 28528561.
^Dünser, M.; Wenzel, V.; Mayr, A. J.; Hasibeder, W. R. (2002-08-01). "Arginin-Vasopressin im vasodilatatorischen Schock". Der Anaesthesist (in German). 51 (8): 650–659. doi:10.1007/s00101-002-0349-y. ISSN 0003-2417. PMID 12391525. S2CID 33545204.
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