Skip to Main content Skip to Navigation
Journal articles

Vasopressor Therapy and the Brain: Dark Side of the Moon

Abstract : Sepsis, a leading cause of morbidity and mortality, is caused by a deregulated host response to pathogens, and subsequent life-threatening organ dysfunctions. All major systems, including the cardiovascular, respiratory, renal, hepatic, hematological, and the neurological system may be affected by sepsis. Sepsis associated neurological dysfunction is triggered by multiple factors including neuro-inflammation, excitotoxicity, and ischemia. Ischemia results from reduced cerebral blood flow, caused by extreme variations of blood pressure, occlusion of cerebral vessels, or more subtle defects of the microcirculation. International guidelines comprehensively describe the initial hemodynamic management of sepsis, revolving around the normalization of systemic hemodynamics and of arterial lactate. By contrast, the management of sepsis patients suffering from brain dysfunction is poorly detailed, the only salient point being mentioned is that sedation and analgesia should be optimized. However, sepsis and the hemodynamic consequences thereof as well as vasopressors may have severe untoward neurological consequences. The current review describes the general neurological complications, as well as the consequences of vasopressor therapy on the brain and its circulation and addresses methods for cerebral monitoring during sepsis. © Copyright © 2020 Heming, Mazeraud, Azabou, Moine and Annane.
Document type :
Journal articles
Complete list of metadatas

https://hal.uvsq.fr/hal-02950833
Contributor : Justine Merlan <>
Submitted on : Monday, September 28, 2020 - 12:20:07 PM
Last modification on : Wednesday, October 14, 2020 - 4:12:36 AM

Links full text

Identifiers

Collections

UVSQ | 2IC

Citation

Nicholas Heming, Aurélien Mazeraud, Eric Azabou, Pierre Moine, Djillali Annane. Vasopressor Therapy and the Brain: Dark Side of the Moon. Frontiers in Medicine, Frontiers media, 2020, 6, pp.317. ⟨10.3389/fmed.2019.00317⟩. ⟨hal-02950833⟩

Share

Metrics

Record views

30