Proper Use of Vasopressors in Septic Shock Introduction

Several factors contribute to organ dysfunction in septic shock patients, and once the inflammatory response has been activated, many organ systems can be adversely affected. A marked fall in systemic vascular resistance results from arterial and venous dilatation. This is accompanied by leakage of plasma into the extravascular space, leading to relative hypovolemia. The microcirculation is adversely affected, with maldistribution of blood flow. Importantly, oxygen is neither reaching nor being effectively extracted by cells, probably because of arteriovenous shunting or abnormalities in cellular metabolism.