The challenging aspect in the treatment of circulatory shock, which is a life-threatening situation, is essentially to look for medications that can improve survival. Among vasoactive agents, none of the currently used catecholamines has been shown to increase survival from circulatory shock, and especially not isoproterenol, noradrenaline or adrenaline. Even with dopamine, that we have known for more than ten years, there is no evidence that survival can be increased. Dobutamine is a younger drug but it does not show any such evidence either at the present time. Therefore, we still need to improve treatment of acute circulatory failure by finding other agents that could increase survival in these conditions.
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