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Clinical Advances in

Vasodilatory Shock: Treating Hypotension to Improve Outcomes

Vasodilatory shock results from multiple causes, of which sepsis is the most common. Nonseptic causes include severe acute pancreatitis, post cardiopulmonary bypass vasoplegia and other triggers for a systemic inflammatory response syndrome. Even brief hypotensive periods can result in myocardial and renal injury, and increased mortality in the critically ill. Further, refractory hypotension has a 30-day all-cause mortality greater than 50%. Our expert faculty shares strategies to optimize current therapies and promising evidence for new therapies for refractory vasodilatory shock.

Supported by an independent educational grant from

La Jolla Pharmaceutical Company

CME Activities

Critical Care


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Related Resources

Downloadable Slide Kit

Treatment of Hypotension in Patients With Shock: Identifying and Overcoming the Barriers

A quick guide on definitions, guidelines, and new strategies for the treatment of hypotension in patients with shock.


Clinical Articles

Chawla LS, Chen S, Bellomo R, et al. Angiotensin converting enzyme defects in shock: implications for future therapy  

Levy MM, Evans Le, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 update. Intensive Care Med. 2018;44:925-928.  

Asfar P, Radermacher P, Ostermann M. MAP of 65: target of the past? Intensive Care Med. 2018;44:1551-1552.  

Maheshwari K, Nathanson BH, Munson SH. The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med. 2018.  

Khanna A, English SW, Wang XS, et al; ATHOS-3 Investigators. Angiotensin II for the treatment of vasodilatory shock. N Engl J Med. 2017;377:419-430.  

Auchet T, Regnier MA, Girerd N, et al. Outcome of patients with septic shock and high-dose vasopressor therapy. Ann Intensive Care. 2017;7:43.  

Venkatesh B, Finfer S, Cohen J, et al. Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med. 2018;378:797-808.  

Related Links

Steering Committee

Ashish K. Khanna, MD

Ashish K. Khanna, MD


Assistant Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine; Staff Intensivist, SICU and Center for Critical Care; Staff Anesthesiologist, Department of General Anesthesiology; Vice-Chief for Research Center for Critical Care, Staff Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio

Thomas Ahrens, PhD, RN

Thomas Ahrens, PhD, RN

Research Scientist, NovEx Novice to Expert Learning, St. Louis, Missouri

Timothy E. Albertson, MD, MPH, PhD

Timothy E. Albertson, MD, MPH, PhD

Professor of Internal Medicine, Pharmacology, Anesthesiology, and Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, California

Mitchell M. Levy, MD, MCCM

Mitchell M. Levy, MD, MCCM

Professor of Medicine, Brown University; Chief, Division of Pulmonary, Critical Care, and Sleep Medicine; Medical Director, MICU Rhode Island Hospital, Providence, Rhode Island

Michael T. McCurdy, MD

Michael T. McCurdy, MD

Associate Professor, Pulmonary and Critical Care Medicine; Associate Professor, Emergency Medicine, University of Maryland School of Medicine; Director, Critical Care Medicine Fellowship; Co-Director, EM-IM/CCM Training Program; Co-Director, Critical Care Access and Flow, University of Maryland Medical Center, Baltimore, Maryland

Daniel I. Sessler, MD

Daniel I. Sessler, MD

Michael Cudahy Professor and Chair, Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio