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Titolo:
Ambulatory norepinephrine treatment of severe autonomic orthostatic hypotension
Autore:
Oldenburg, O; Mitchell, A; Nurnberger, J; Koeppen, S; Erbel, R; Philipp, T; Kribben, A;
Indirizzi:
Univ Hosp Essen, Dept Cardiol, Div Internal Med, D-45122 Essen, Germany Univ Hosp Essen Essen Germany D-45122 ternal Med, D-45122 Essen, Germany Univ Hosp Essen, Dept Hypertens & Nephrol, Div Internal Med, Essen, Germany Univ Hosp Essen Essen Germany Nephrol, Div Internal Med, Essen, Germany Univ Hosp Essen, Neurol Clin, Essen, Germany Univ Hosp Essen Essen Germany v Hosp Essen, Neurol Clin, Essen, Germany
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 1, volume: 37, anno: 2001,
pagine: 219 - 223
SICI:
0735-1097(200101)37:1<219:ANTOSA>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
SYNCOPE; INTOLERANCE; MANAGEMENT; DISORDERS; YOHIMBINE; DIAGNOSIS; FAILURE; TILT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Oldenburg, O Univ Hosp Essen, Dept Cardiol, Div Internal Med, Hufelandstr 55, D-45122 Essen, Germany Univ Hosp Essen Hufelandstr 55 Essen Germany D-45122 Germany
Citazione:
O. Oldenburg et al., "Ambulatory norepinephrine treatment of severe autonomic orthostatic hypotension", J AM COL C, 37(1), 2001, pp. 219-223

Abstract

OBJECTIVES This study was designed to establish a patient-controlled, ambulatory norepinephrine treatment of refractory orthostatic hypotension due to primary autonomic failure. BACKGROUND Autonomic dysfunction leads to disabling postural hypotension. Particularly in primary autonomic dysfunction, repeated syncope and immobilization can be the result. Medical treatment of orthostatic hypotension often fails in advanced cases. METHODS Ambulatory, patient-controlled norepinephrine therapy was initiated in six patients with orthostatic hypotension due to primary autonomic failure that had been refractory to conventional treatment. Before this therapy, three patients were bedridden; one was immobilized in a wheelchair. All had recurrent syncope and tolerated upright tilt-table testing for less than 15 min despite extensive medical treatment. For ambulatory treatment, a port-a-cath system was implanted and, using a CADD ambulatory infusion pump,norepinephrine was infused in individually adjusted dosages. RESULTS Norepinephrine infusion therapy enabled all patients to sit, stay and walk around for more than 45 min. One patient died after a five-year treatment period, another after nine months because of nonhemorrhagic brain stem infarctions, both in the absence of norepinephrine treatment. The remaining four patients are still mobile after a period of 19, 10, 9 and 7 months, respectively. None of them has suffered complications due to arterial hypo- or hypertension, and there has been no infection of the infusion system. CONCLUSIONS In these selected patients with refractory orthostatic hypotension due to primary autonomic dysfunction, ambulatory norepinephrine infusion therapy has proved to be a promising new therapeutic option. Further long-term studies including more patients are necessary to assess additional indications, reliability and safety of this new method. CT Am Cell Cardiol 2001;37: 219-23) (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 12:57:05