Uso de fármacos Inotrópicos y Vasopresores en el Choque Distributivo, artículo de revisión

Abstract

The use of inotropic and vasopressor drugs in the management of distributive shock is common in emergency departments. The aim of inotropic therapy is to minimize adverse outcomes due to cardiovascular compromise; its use is currently guided by the underlying pathophysiology of such compromise. However, it has been seen that the use of inotropic drugs does not significantly reduce the morbidity and mortality associated with cardiovascular dysfunction, which indicates that there are still gaps in our knowledge of the circulation and the action of inotropic drugs on it. On the other hand, vasopressors are the optimal treatment when blood pressure does not reach normal parameters despite the initiation of intravenous fluids. Materials and methods: A review of the medical literature was carried out in the main academic databases such as: Cochrane Library, Clinical Key, Pubmed, Science Direct, Springer Link, about the different therapeutic options, discarding all unconfirmed information or without updated bibliographic references from the last 5 years. Results: The first-line drug, due to its lower mortality rate and its ability not to generate arrhythmias, is norepinephrine. Dopamine can be used in cases in which the patient does not present arrhythmias and has a marked bradycardia. The use of other drugs is related to adverse effects depending on the type of patient.