scholarly journals Influence of vasopressor agent in pediatric septic shock mortality

Critical Care ◽  
2011 ◽  
Vol 15 (S2) ◽  
Author(s):  
CMF Mangia ◽  
LPS Jose ◽  
FL Monteiro ◽  
AT Fernandes ◽  
P Biasi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Vasopressor Agent

scholarly journals Renal autoregulation in experimental septic shock and its response to vasopressin and norepinephrine administration

2018 ◽  
Vol 125 (6) ◽  
pp. 1661-1669 ◽  
Author(s):  
Emiel Hendrik Post ◽  
Fuhong Su ◽  
Cláudia Righy Shinotsuka ◽  
Fabio Silvio Taccone ◽  
Jacques Creteur ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Septic Shock ◽  
Arterial Hypertension ◽  
Pressure Management ◽  
Blood Pressure Targets ◽  
Renal Autoregulation ◽  
Blood Pressure Management ◽  
Specific Effects ◽  
Vasopressor Agent ◽  
Sepsis Induction

Evidence suggests that septic shock patients with chronic arterial hypertension may benefit from resuscitation targeted to achieve higher blood pressure values than other patients, possibly as a result of altered renal autoregulation. The effects of different vasopressor agents on renal autoregulation may be important in this context. We investigated the effects of arginine vasopressin (AVP) and norepinephrine (NE) on renal autoregulation in ovine septic shock. Sepsis was induced by fecal peritonitis. When shock developed (decrease in mean arterial pressure to <65 mmHg and no fluid responsiveness), animals were randomized to receive NE or AVP in a crossover design. Before the switch to the second vasopressor, the first vasopressor was discontinued for 30 min to ensure complete washout of the first vasopressor. Renal autoregulation was evaluated by recording the change in renal blood flow (RBF) in response to manual, stepwise reductions in renal inflow pressure. In this model, the lower limit of renal autoregulation was not significantly altered 6 h after sepsis induction (59 ± 9 vs. 64 ± 7 mmHg at baseline, P = 0.096). After development of shock, the autoregulatory threshold was lower with AVP than with NE (59 ± 5 vs. 65 ± 7 mmHg, P = 0.010). However, RBF was higher with NE both at the start of autoregulatory measurements (206 ± 58 vs. 170 ± 52 ml/min; P = 0.049) and at the autoregulatory threshold (191 ± 53 vs. 150 ± 47 ml/min; P = 0.008). As vasopressors may have different effects on renal autoregulation, blood pressure management in patients with septic shock should be individualized and take into account drug-specific effects. NEW & NOTEWORTHY Septic shock patients with chronic arterial hypertension may benefit from higher blood pressure targets due to underlying deficits in renal autoregulatory efficiency. The current study is the first to show that the choice of vasopressor agent can differentially affect renal autoregulation. These findings may contribute to more personalized blood pressure management in patients with septic shock.

Influence of vasopressor agent in septic shock mortality. Results from the Portuguese Community-Acquired Sepsis Study (SACiUCI study)*

2009 ◽  
Vol 37 (2) ◽  
pp. 410-416 ◽  
Author(s):  
Pedro R. Póvoa ◽  
António H. Carneiro ◽  
Orquídea S. Ribeiro ◽  
Altamiro C. Pereira
Keyword(s):  
Septic Shock ◽  
Vasopressor Agent

Low-Dose Steroids Cut Mortality in Septic Shock

2006 ◽  
Vol 36 (19) ◽  
pp. 24
Author(s):  
BRUCE JANCIN
Keyword(s):  
Septic Shock ◽  
Low Dose

Septic shock patient and ultrasound in the emergency room

2016 ◽  
Vol 37 (S 01) ◽  
Author(s):  
M Algaba Montes ◽  
AÁ Oviedo García ◽  
M Patricio Bordomás
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Septic Shock Patient

Combination of Antibiotic Treatment with the Thrombin Inhibitor Recombinant Hirudin for the Therapy of Experimental Klebsiella pneumoniae Sepsis

1994 ◽  
Vol 71 (06) ◽  
pp. 768-772 ◽  
Author(s):  
Gerhard Dickneite ◽  
Jörg Czech
Keyword(s):  
Septic Shock ◽  
Klebsiella Pneumoniae ◽  
Organ Failure ◽  
Therapeutic Effect ◽  
Disseminated Intravascular Coagulation ◽  
Post Infection ◽  
Thrombin Inhibitor ◽  
Bolus Administration ◽  
Bacterial Burden ◽  
Recombinant Hirudin

SummaryRats which were infected with the gramnegative pathogen Klebsiella pneumoniae develop disseminated intravascular coagulation (DIC), multi-organ failure (MOF) and finally die in a septic shock. We investigated the therapeutic effect of antibiotic (tobramycin) treatment combined with the infusion of the highly specific thrombin inhibitor rec. hirudin. Although administration of 2 mg/kg tobramycin alone leads to a decrease of the bacterial burden, DIC could not be prevented. Infusion of rec. hirudin (0.25 mg/kg x h) for 4 h (start of treatment 1 h post infection), in addition to a bolus administration of tobramycin, led to an amelioration of DIC parameters as fibrinogen, thrombin-antithrombin complex (TAT) and platelets. Serum transaminase levels (GOT, GPT) as a marker of MOF were significantly improved by rec. hirudin, the T50 value increased from 17 h in the tobramycin group to 42 h in the tobramycin + rec. hirudin giuup, muilality rates were 90% or 60%, respectively. Combination of heparin (10011/kg x h) and tobramycin was not effective on survival.

Evidence for impaired 21-hydroxylase activity in patients with septic shock

2004 ◽  
Vol 112 (S 1) ◽  
Author(s):  
MWA Angstwurm ◽  
A Rashidi-Kia ◽  
M Bidlingmeier ◽  
J Schopohl ◽  
R Gaertner
Keyword(s):  
Septic Shock ◽  
Hydroxylase Activity
Sign in / Sign up

Export Citation Format

Share Document