Blood Pressure Targets for Adults with Vasodilatory Shock — An Individual Patient Data Meta-Analysis

Angriman, Federico; Momenzade, Neda; Adhikari, Neill K. J.; Mouncey, Paul R.; Asfar, Pierre; Yarnell, Christopher J.; Ong, Sean Wei Xiang; Pinto, Ruxandra; Doidge, James C.; Shankar-Hari, Manu; Harhay, Michael O.; Masse, Marie-Hélène; Harrison, David A.; Rowan, Kathryn M.; Li, Fan; Carter, Francis; Camirand-Lemyre, Felix; Lamontagne, François

doi:10.1056/evidoa2400359

NEJM Evidence

2025

DOI: 10.1056/evidoa2400359

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Blood Pressure Targets for Adults with Vasodilatory Shock — An Individual Patient Data Meta-Analysis

Federico Angriman,

Neda Momenzade,

Neill K. J. Adhikari

et al.

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When Less Is More — Revisiting Hemodynamic Targets in Vasodilatory Shock

Alladina

2025

NEJM Evidence

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When Less Is More — Revisiting Hemodynamic Targets in Vasodilatory Shock

Alladina

2025

NEJM Evidence

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Vasopressor Therapy

Vincent,

Annoni

2024

JCM

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Vasopressor therapy represents a key part of intensive care patient management, used to increase and maintain vascular tone and thus adequate tissue perfusion in patients with shock. Norepinephrine is the preferred first-line agent because of its reliable vasoconstrictor effects, with minimal impact on heart rate, and its mild inotropic effects, helping to maintain cardiac output. Whichever vasopressor is used, its effects on blood flow must be considered and excessive vasoconstriction avoided. Other vasoactive agents include vasopressin, which may be considered in vasodilatory states, and angiotensin II, which may be beneficial in patients with high renin levels, although more data are required to confirm this. Dobutamine should be considered, along with continued fluid administration, to help maintain adequate tissue perfusion in patients with reduced oxygen delivery. In this narrative review, we consider the different vasopressor agents, focusing on the importance of tailoring therapy to the individual patient and their hemodynamic response.

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Blood Pressure Targets for Adults with Vasodilatory Shock — An Individual Patient Data Meta-Analysis

Cited by 2 publications

References 43 publications

When Less Is More — Revisiting Hemodynamic Targets in Vasodilatory Shock

When Less Is More — Revisiting Hemodynamic Targets in Vasodilatory Shock

Vasopressor Therapy

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