Show simple item record

dc.contributor.authorLambden, Simon
dc.contributor.authorCreagh-Brown, Ben C
dc.contributor.authorHunt, Julie
dc.contributor.authorSummers, Charlotte
dc.contributor.authorForni, Lui G
dc.date.accessioned2018-11-23T00:30:38Z
dc.date.available2018-11-23T00:30:38Z
dc.date.issued2018-07-06
dc.identifier.issn1364-8535
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/285748
dc.description.abstractVasoplegia is the syndrome of pathological low systemic vascular resistance, the dominant clinical feature of which is reduced blood pressure in the presence of a normal or raised cardiac output. The vasoplegic syndrome is encountered in many clinical scenarios, including septic shock, post-cardiac bypass and after surgery, burns and trauma, but despite this, uniform clinical definitions are lacking, which renders translational research in this area challenging. We discuss the role of vasoplegia in these contexts and the criteria that are used to describe it are discussed. Intrinsic processes which may drive vasoplegia, such as nitric oxide, prostanoids, endothelin-1, hydrogen sulphide and reactive oxygen species production, are reviewed and potential for therapeutic intervention explored. Extrinsic drivers, including those mediated by glucocorticoid, catecholamine and vasopressin responsiveness of the blood vessels, are also discussed. The optimum balance between maintaining adequate systemic vascular resistance against the potentially deleterious effects of treatment with catecholamines is as yet unclear, but development of novel vasoactive agents may facilitate greater understanding of the role of the differing pathways in the development of vasoplegia. In turn, this may provide insights into the best way to care for patients with this common, multifactorial condition.
dc.format.mediumElectronic
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectShock, Septic
dc.subjectAnaphylaxis
dc.subjectHydrogen Sulfide
dc.subjectFree Radicals
dc.subjectProstaglandins
dc.subjectVascular Resistance
dc.subjectVasoplegia
dc.titleDefinitions and pathophysiology of vasoplegic shock.
dc.typeArticle
prism.issueIdentifier1
prism.publicationDate2018
prism.publicationNameCrit Care
prism.startingPage174
prism.volume22
dc.identifier.doi10.17863/CAM.33092
dcterms.dateAccepted2018-06-19
rioxxterms.versionofrecord10.1186/s13054-018-2102-1
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-07-06
dc.contributor.orcidLambden, Simon [0000-0003-4531-4524]
dc.contributor.orcidCreagh-Brown, Ben C [0000-0002-4397-1232]
dc.contributor.orcidSummers, Charlotte [0000-0002-7269-2873]
dc.identifier.eissn1466-609X
rioxxterms.typeJournal Article/Review
cam.issuedOnline2018-07-06


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record

Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International