Τίτλος:
Refractory septic shock: Efficacy and safety of very high doses of norepinephrine
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The aim of Ms study was to evaluate the safety, efficacy, and effects of administration of very high doses of norepinephrine (>4 μg kg-1 min-1) in catecholamine-resistant septic shock. We reviewed the charts of all patients with nonresponding to commonly used norepinephrine doses (≤4 μg kg-1 min-1) septic shock from January 1999 to December 2002 in our Surgical Intensive Care Unit. All patients were treated with high norepinephrine doses (>4 μg kg-1 min-1), after initial resuscitation, so as to achieve a mean arterial pressure higher than or equal to 65 mmHg. During this 4-year period, 12 consecutive patients with catecholamine-resistant septic shock were included in our study. When compared with the values obtained prior to the administration of very high norepinephrine doses, the values of mean arterial pressure (p = 0.003) and systemic vascular resistance (p = 0.002) significantly increased after the administration of such doses, and additionally, lactate concentrations (p = 0.003) decreased. In contrast, no significant changes were observed regarding mean central venous pressure, pulmonary capillary wedge pressure, and pulmonary arterial pressure. Administration of high norepinephrine doses in our patients resulted in a survival rate of 33.4%. Management of catecholamine-resistant septic shock patients poses a challenging problem. Administration of very high norepinephrine doses is safe and effective and may improve survival of these patients with otherwise extremely high mortality rates. © 2006 Prous Science. All rights reserved.
Συγγραφείς:
Katsaragakis, S.
Kapralou, A.
Theodorou, D.
Markogiannakis, H.
Larentzakis, A.
Stamou, K.M.
Drimousis, P.
Bramis, I.
Περιοδικό:
Methods and Findings in Experimental and Clinical Pharmacology
Λέξεις-κλειδιά:
antibiotic agent; catecholamine; noradrenalin, acute pancreatitis; adult; aged; arterial pressure; central venous pressure; clinical article; controlled study; dose response; drug effect; drug efficacy; drug megadose; drug safety; female; human; intensive care unit; lung capillary pressure; male; peritonitis; review; septic shock; survival rate; systemic vascular resistance, Aged; APACHE; Blood Pressure; Dose-Response Relationship, Drug; Female; Heart Rate; Humans; Male; Middle Aged; Norepinephrine; Retrospective Studies; Shock, Septic; Vasoconstrictor Agents
DOI:
10.1358/mf.2006.28.5.990203
