Insights into haemorrhagic shock: A narrative review of pathophysiology and vasopressor options

Abstract

Haemorrhagic shock is a critical condition characterised by decreased circulating blood volume due to significant fluid or blood loss, resulting in impaired tissue perfusion and oxygen delivery. The management of haemorrhagic shock requires an understanding of its complex pathophysiology and the implementation of appropriate treatment strategies. This review focuses on the role of vasopressors in the management of haemorrhagic shock, addressing the current understanding of its pathophysiology and the use of vasopressors. The review evaluates the use of different vasopressors, including norepinephrine, epinephrine, phenylephrine and vasopressin, in the context of different studies that examined their impact on mortality and patient outcomes. While some studies suggest a potential benefit from the use of vasopressors, others suggest an increased mortality associated with their use. However, studies of vasopressin show conflicting results, suggesting its potential efficacy in reducing blood product transfusion and mortality.

Further research is needed to clarify the role of vasopressors in the management of haemorrhagic shock. This review highlights the need for further research, including prospective clinical trials, to elucidate the optimal use of vasopressors in the management of haemorrhagic shock. Understanding the pathophysiology and taking into account individual patient factors is essential to guide vasopressor therapy to improve outcomes in patients with haemorrhagic shock.