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Titolo:
Inotrope/vasopressor support in sepsis-induced organ hypoperfusion
Autore:
Vincent, JL; De Backer, D;
Indirizzi:
Free Univ Brussels, Erasme Univ Hosp, Dept Intens Care, B-1070 Brussels, Belgium Free Univ Brussels Brussels Belgium B-1070 are, B-1070 Brussels, Belgium
Titolo Testata:
SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE
fascicolo: 1, volume: 22, anno: 2001,
pagine: 61 - 73
SICI:
1069-3424(2001)22:1<61:ISISOH>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-DOSE DOPAMINE; SPLANCHNIC BLOOD-FLOW; GASTRIC-MUCOSAL PH; CRITICALLY ILL PATIENTS; HUMAN SEPTIC SHOCK; INTESTINAL VILLUS MICROCIRCULATION; REGIONAL OXYGEN-UPTAKE; INTRAMUCOSAL PH; RENAL-FUNCTION; NORMOTENSIVE SEPSIS;
Keywords:
splanchnic circulation; gastric tonometry; adrenergic agents; circulatory shock; multiple organ failure;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
128
Recensione:
Indirizzi per estratti:
Indirizzo: Vincent, JL Free Univ Brussels, Erasme Univ Hosp, Dept Intens Care, Route Lennik 808, B-1070 Brussels, Belgium Free Univ Brussels Route Lennik 808 Brussels Belgium B-1070 m
Citazione:
J.L. Vincent e D. De Backer, "Inotrope/vasopressor support in sepsis-induced organ hypoperfusion", SEM RESP CR, 22(1), 2001, pp. 61-73

Abstract

Vasoactive agents are commonly required in the management of septic shock not only to restore a sufficient tissue perfusion pressure but also to increase blood flow and oxygen delivery to the organs. Importantly, vasoactive agents are no substitute for fluid therapy. Defining end points for therapyremains difficult. These should be, above all, clinical. Even though the gut may play an important role in the development of multiple organ failure,the use of gastric tonometry to guide therapy cannot be recommended at this time. Study of the microcirculation at the bedside with orthogonal polarization spectral imaging may be helpful in the future. Adrenergic agents arethe preferred agents for hemodynamic stabilization. Dopamine and norepinephrine are the drugs of choice to increase arterial pressure. Dobutamine remains the agent of choice to increase blood flow to the organs, including the gut and the kidneys. Many questions remain unanswered with respect to optimal hemodynamic management of septic shock.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 09:24:09