Vasopressors for hypotensive shock
Citation: Gamper G, Havel C, Arrich J, et al. Vasopressors for hypotensive shock. Cochrane Database of Systematic Reviews 2016; (2): CD003709
What is this? Some patients with COVID-19 will become critically ill and may develop hypotensive shock, but there is uncertainty about the most beneficial way to treat this. Vasopressors have shown evidence of benefit in hypotensive shock, probably because of their ability to raise blood pressure. Their effects for patients with hypotensive shock caused by other factors might indicate their effects in patients with COVID-19.
In this Cochrane systematic review, the authors searched for randomized trials comparing different vasopressor regimens on mortality in critically ill patients with hypotensive shock. They did not restrict by date, type or language of publication and did their most recent search in June 2015. They identified 28 studies (3497 participants), covering six different vasopressors.
What works: Vasopressor therapy is an important part of haemodynamic support for patients with shock.
What doesn’t work: Nothing noted.
What’s uncertain: It is uncertain whether any of the vasopressors at assessed doses are superior to others for mortality.
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