The Future and Current Status of Vasopressors in Septic Shock

Two excellent articles recently published Online only and in the European Journal of Intensive Care Medicine

1. Challenges in the management of septic shock: a narrative review


2.A global perspective on vasoactive agents in shock



I actually use vasopressin way early when NE is still at levels < 10 mcg/ min in elderly patients generally with known paroxysmal AF/AFL, LV dysfunction and/or recent ECHO shows LAE ( >40 mm); younger patients with H/O rheumatic heart disease I would include ,also- essentially anybody I thought would be at higher then normal risk for new onset or recurrent AF/AFL

Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive ShockA Systematic Review and Meta-analysis