[Vasopressors: Physiology, Pharmacology and Clinical Applications].

Vasopressors are widely used in anaesthesiology and critical care medicine, to treat harmless (e.g. anaesthesia-induced hypotension) as well as life-threatening conditions (e.g. septic shock). Some clinically used vasopressors resemble endogenous substances - such as norepinephrine - while others have been artificially synthesized (e.g. phenylephrine). Most of the substances used in different clinical scenarios have various effects except for vasoconstriction alone. Therefore, a thorough understanding of the pharmacology and clinical profile of every single substance is of highest importance prior to practical usage. Furthermore, the fundamentals of vascular physiology and vasotonic regulation are mandatory to safely provide vasopressor-based therapies. This article covers the essentials of physiology and pharmacology of vasopressors, and the clinical settings they are used in (e.g. septic shock, vasoplegic shock after cardiac surgery, trauma-induced hypotension). Vasopressoren kommen besonders in kritischen, nicht selten lebensbedrohlichen Situationen der Anästhesie, Notfall- und Intensivmedizin zum Einsatz. Die Wahl der geeigneten Substanz sowie die Erkennung und Beherrschung möglicher Nebenwirkungen sind von großer Bedeutung. Im folgenden Beitrag sollen daher die klinisch wichtigsten Substanzen vorgestellt und deren pharmakologische Charakteristika beleuchtet werden.

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