Actualización en el manejo de fármacos vasoactivos en insuficiencia cardiaca aguda y shock cardiogénico y mixto

Vasoactive drugs can have inotropic or vasomotor properties or both. Variability in responses to these drugs can be explained by factors related to the dose used, the drugs' affinity for specific receptors, the density and selectivity of these receptors, and the operation of complex signaling pathways. Indications for their use should not be based solely on recommended blood pressure thresholds but should also take into account objective microcirculatory parameters. To date, no vasoactive drug has been shown to increase survival, and the main criticism of their use is that they produce serious adverse effects. Research has focused on finding more selective compounds that will avoid these adverse effects and has not only sought to achieve short-term improvements in symptoms and hemodynamics.