ISICEM 2018: Getting a grip on catecholaminergic stress

The aim of catecholaminergic vasopressor therapy (e.g., noradrenaline )is to counteract hypotension in cardiac surgery and sepsis patients – but unfortunately, increasing dosages also imply increasing rates of severe side effects. One, severity and duration of hypotension are associated with negative outcomes, and two, catecholaminergic vasopressors may cause adverse cardiac toxicities. Argipressin is particularly suited as vasopressor compared to NA, as due to its mechanism of action over V1- and V2-receptors there are no negative effects on kidney, pulmonary circulation or cardiac system.

The highly cardioselective iv beta-blocker landiolol seems to be a promising option to minimize catecholaminergic hyperactivity and its sequelae arrhythmias such as postoperative atrial fibrillation. In addition, landiolol may allow for a better control of tachycardic arrhythmias during sepsis than the currently available drugs.

A detailed version can be found in the following article:

Decatecholaminization in cardiac surgery and sepsis, Preprint, June 2018, Springer Verlag

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