In this commentary, the authors propose the concept of “broad spectrum vasopressors” wherein patients with septic shock are started on multiple vasopressors with a different mechanism of action simultaneously while the vasopressor sensitivity is assessed. Once the vasopressor sensitivities are assessed, ...
Inotropic agents prolong the action potential plateau duration, increasing [Ca2+]i, calcium release from the sarcoplasmic reticulum and hence, contractility. Myocyte stretch also affects myfilament sensitivity to [Ca2+]i, a mechanism exploited in the use of certain novel inotropic drugs. Vascular ...
In cases of "refractory" septic shock, adding another vasopressor with a different mechanism of action (non-adrenergic) could be considered. Vasopressin has ben shown to be a valuable alternative agent, while promizing data have been reported with the use of angiotensin.Ortiz, Julian Arias...
Inotropes have been sub-classified into calcitropes, myotropes and mitotropes based on their mechanism of action. However, in practice most inotropes in clinical use in the intensive care unit are calcitropes, and sub-classified into inodilators and inoconstrictors, based on their concomitant ...