Epinephrine impairs splanchnic perfusion in septic shock
OBJECTIVETo assess the effects of epinephrine on splanchnic perfusion and splanchnic oxygen uptake in patients with septic shock. DESIGNProspective, controlled trial. SETTINGUniversity hospital intensive care unit (ICU). PATIENTSEight patients with septic shock, according to the criteria of the 1992...
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| Veröffentlicht in: | Critical care medicine 1997-03, Vol.25 (3), p.399-404 |
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| creator | Meier-Hellmann, Andreas Reinhart, Konrad Bredle, Donald L Specht, Martin Spies, Claudia D Hannemann, Lutz |
| description | OBJECTIVETo assess the effects of epinephrine on splanchnic perfusion and splanchnic oxygen uptake in patients with septic shock.
DESIGNProspective, controlled trial.
SETTINGUniversity hospital intensive care unit (ICU).
PATIENTSEight patients with septic shock, according to the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, requiring treatment with vasopressors.
INTERVENTIONSWe compared in crossover design a 2-hr infusion of epinephrine with dobutamine plus norepinephrine in eight ICU patients with septic shock. Systemic and splanchnic hemodynamics and oxygen transport were measured before and during treatment with epinephrine.
MEASUREMENTS AND MAIN RESULTSThere was essentially no effect of epinephrine on the global parameters, except for increased lactate concentrations. There were marked effects on the regional variables; epinephrine caused lower splanchnic flow and oxygen uptake, lower mucosal pH, and higher hepatic vein lactate.
CONCLUSIONWe conclude that undesirable splanchnic effects on patients in whom that region is particularly fragile should be considered when using epinephrine for septic shock treatment. (Crit Care Med 1997; 25:399-404) |
| doi_str_mv | 10.1097/00003246-199703000-00005 |
| format | Article |
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DESIGNProspective, controlled trial.
SETTINGUniversity hospital intensive care unit (ICU).
PATIENTSEight patients with septic shock, according to the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, requiring treatment with vasopressors.
INTERVENTIONSWe compared in crossover design a 2-hr infusion of epinephrine with dobutamine plus norepinephrine in eight ICU patients with septic shock. Systemic and splanchnic hemodynamics and oxygen transport were measured before and during treatment with epinephrine.
MEASUREMENTS AND MAIN RESULTSThere was essentially no effect of epinephrine on the global parameters, except for increased lactate concentrations. There were marked effects on the regional variables; epinephrine caused lower splanchnic flow and oxygen uptake, lower mucosal pH, and higher hepatic vein lactate.
CONCLUSIONWe conclude that undesirable splanchnic effects on patients in whom that region is particularly fragile should be considered when using epinephrine for septic shock treatment. (Crit Care Med 1997; 25:399-404)</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/00003246-199703000-00005</identifier><identifier>PMID: 9118653</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: Williams & Wilkins</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cardiovascular system ; Cross-Over Studies ; Dobutamine - therapeutic use ; Drug Therapy, Combination ; Epinephrine - therapeutic use ; Female ; Hemodynamics - drug effects ; Humans ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Norepinephrine - therapeutic use ; Oxygen Consumption - drug effects ; Pharmacology. Drug treatments ; Prospective Studies ; Shock, Septic - drug therapy ; Shock, Septic - physiopathology ; Splanchnic Circulation - drug effects ; Sympathomimetics - therapeutic use ; Vasoconstrictor Agents - therapeutic use</subject><ispartof>Critical care medicine, 1997-03, Vol.25 (3), p.399-404</ispartof><rights>Williams & Wilkins 1997. All Rights Reserved.</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4505-2d21cdda2046016fef273d7793b8227a63a32664bffc2b9e7d74a28fbca6bdde3</citedby><cites>FETCH-LOGICAL-c4505-2d21cdda2046016fef273d7793b8227a63a32664bffc2b9e7d74a28fbca6bdde3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2634388$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9118653$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meier-Hellmann, Andreas</creatorcontrib><creatorcontrib>Reinhart, Konrad</creatorcontrib><creatorcontrib>Bredle, Donald L</creatorcontrib><creatorcontrib>Specht, Martin</creatorcontrib><creatorcontrib>Spies, Claudia D</creatorcontrib><creatorcontrib>Hannemann, Lutz</creatorcontrib><title>Epinephrine impairs splanchnic perfusion in septic shock</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVETo assess the effects of epinephrine on splanchnic perfusion and splanchnic oxygen uptake in patients with septic shock.
DESIGNProspective, controlled trial.
SETTINGUniversity hospital intensive care unit (ICU).
PATIENTSEight patients with septic shock, according to the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, requiring treatment with vasopressors.
INTERVENTIONSWe compared in crossover design a 2-hr infusion of epinephrine with dobutamine plus norepinephrine in eight ICU patients with septic shock. Systemic and splanchnic hemodynamics and oxygen transport were measured before and during treatment with epinephrine.
MEASUREMENTS AND MAIN RESULTSThere was essentially no effect of epinephrine on the global parameters, except for increased lactate concentrations. There were marked effects on the regional variables; epinephrine caused lower splanchnic flow and oxygen uptake, lower mucosal pH, and higher hepatic vein lactate.
CONCLUSIONWe conclude that undesirable splanchnic effects on patients in whom that region is particularly fragile should be considered when using epinephrine for septic shock treatment. (Crit Care Med 1997; 25:399-404)</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Cross-Over Studies</subject><subject>Dobutamine - therapeutic use</subject><subject>Drug Therapy, Combination</subject><subject>Epinephrine - therapeutic use</subject><subject>Female</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Norepinephrine - therapeutic use</subject><subject>Oxygen Consumption - drug effects</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>Shock, Septic - drug therapy</subject><subject>Shock, Septic - physiopathology</subject><subject>Splanchnic Circulation - drug effects</subject><subject>Sympathomimetics - therapeutic use</subject><subject>Vasoconstrictor Agents - therapeutic use</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctOxCAUhonRjOPoI5h0YdxVuRXK0ky8JZO40TWhFFKcXhDaTHx7GafOThaQ85_vXPIDQIbgHYKC38N0CKYsR0JwSFKU76XiBCxRQVKABTkFSwgFzAkV5BxcxPgJIaIFJwuwEAiVrCBLUD561xvfhHRnrvPKhZhF36peN73TmTfBTtENfeb6LBo_Ji02g95egjOr2miu5ncFPp4e39cv-ebt-XX9sMk1LWCR4xojXdcKQ8ogYtZYzEnNuSBViTFXjCiCGaOVtRpXwvCaU4VLW2nFqro2ZAVuD319GL4mE0fZuahNmzY0wxQlLwUqmKAJLA-gDkOMwVjpg-tU-JYIyr1p8s80eTTtVypS6fU8Y6o6Ux8LZ5dS_mbOq6hVa0Nyx8UjhhmhpCwTRg_YbmhHE-K2nXYmyMaodmzkf19GfgB1iIOe</recordid><startdate>199703</startdate><enddate>199703</enddate><creator>Meier-Hellmann, Andreas</creator><creator>Reinhart, Konrad</creator><creator>Bredle, Donald L</creator><creator>Specht, Martin</creator><creator>Spies, Claudia D</creator><creator>Hannemann, Lutz</creator><general>Williams & Wilkins</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199703</creationdate><title>Epinephrine impairs splanchnic perfusion in septic shock</title><author>Meier-Hellmann, Andreas ; Reinhart, Konrad ; Bredle, Donald L ; Specht, Martin ; Spies, Claudia D ; Hannemann, Lutz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4505-2d21cdda2046016fef273d7793b8227a63a32664bffc2b9e7d74a28fbca6bdde3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Cross-Over Studies</topic><topic>Dobutamine - therapeutic use</topic><topic>Drug Therapy, Combination</topic><topic>Epinephrine - therapeutic use</topic><topic>Female</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Norepinephrine - therapeutic use</topic><topic>Oxygen Consumption - drug effects</topic><topic>Pharmacology. Drug treatments</topic><topic>Prospective Studies</topic><topic>Shock, Septic - drug therapy</topic><topic>Shock, Septic - physiopathology</topic><topic>Splanchnic Circulation - drug effects</topic><topic>Sympathomimetics - therapeutic use</topic><topic>Vasoconstrictor Agents - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meier-Hellmann, Andreas</creatorcontrib><creatorcontrib>Reinhart, Konrad</creatorcontrib><creatorcontrib>Bredle, Donald L</creatorcontrib><creatorcontrib>Specht, Martin</creatorcontrib><creatorcontrib>Spies, Claudia D</creatorcontrib><creatorcontrib>Hannemann, Lutz</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meier-Hellmann, Andreas</au><au>Reinhart, Konrad</au><au>Bredle, Donald L</au><au>Specht, Martin</au><au>Spies, Claudia D</au><au>Hannemann, Lutz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epinephrine impairs splanchnic perfusion in septic shock</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>1997-03</date><risdate>1997</risdate><volume>25</volume><issue>3</issue><spage>399</spage><epage>404</epage><pages>399-404</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVETo assess the effects of epinephrine on splanchnic perfusion and splanchnic oxygen uptake in patients with septic shock.
DESIGNProspective, controlled trial.
SETTINGUniversity hospital intensive care unit (ICU).
PATIENTSEight patients with septic shock, according to the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, requiring treatment with vasopressors.
INTERVENTIONSWe compared in crossover design a 2-hr infusion of epinephrine with dobutamine plus norepinephrine in eight ICU patients with septic shock. Systemic and splanchnic hemodynamics and oxygen transport were measured before and during treatment with epinephrine.
MEASUREMENTS AND MAIN RESULTSThere was essentially no effect of epinephrine on the global parameters, except for increased lactate concentrations. There were marked effects on the regional variables; epinephrine caused lower splanchnic flow and oxygen uptake, lower mucosal pH, and higher hepatic vein lactate.
CONCLUSIONWe conclude that undesirable splanchnic effects on patients in whom that region is particularly fragile should be considered when using epinephrine for septic shock treatment. (Crit Care Med 1997; 25:399-404)</abstract><cop>Hagerstown, MD</cop><pub>Williams & Wilkins</pub><pmid>9118653</pmid><doi>10.1097/00003246-199703000-00005</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Biological and medical sciences Cardiovascular system Cross-Over Studies Dobutamine - therapeutic use Drug Therapy, Combination Epinephrine - therapeutic use Female Hemodynamics - drug effects Humans Male Medical sciences Middle Aged Miscellaneous Norepinephrine - therapeutic use Oxygen Consumption - drug effects Pharmacology. Drug treatments Prospective Studies Shock, Septic - drug therapy Shock, Septic - physiopathology Splanchnic Circulation - drug effects Sympathomimetics - therapeutic use Vasoconstrictor Agents - therapeutic use |
| title | Epinephrine impairs splanchnic perfusion in septic shock |
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