Targeting the microcirculation in resuscitation of patients with septic shock: fluid is superior to norepinephrine
نویسندگان
چکیده
Methods This was a single centre prospective study. Patients in septic shock for less than 24 hours despite fluid resuscitation were enrolled. Passive leg raising test was performed to predict fluid responsiveness. Responders were randomizedly divided into two groups, i.e. Resp-FL group and Resp-NE group to maintain usual MAP. In Resp-FL group, patients were treated by fluid until with no response to passive leg raising test, then the MAP was titrated to usual level by NE. In Resp-NE group, doses of NE were adjusted to maintain usual level of MAP directly. Nonresponders were enrolled in Nonresp group, MAP was titrated to usual MAP by norepinephrine.
منابع مشابه
The International Sepsis Forum's controversies in sepsis: my initial vasopressor agent in septic shock is norepinephrine rather than dopamine
Vasopressor agents are often used in patients with septic shock when aggressive fluid resuscitation fails to correct hypotension. Dopamine and norepinephrine are two such vasopressor agents. In the past, fear of potential excessive vasoconstriction, with resultant end-organ hypoperfusion, restricted the use of norepinephrine in septic shock, relegating it to a second-line agent. However, recent...
متن کاملEffect of Higher Mean Arterial Pressure with Norepinephrine on Tissue Oxygenation and Perfusion in Patients of Septic Shock
The current survival sepsis guideline proposes the use of vasopressors and fluid resuscitation to maintain the mean arterial pressure (MAP) ≥ 65 mmHg. Titrating catecholamine infusion to achieve higher MAP has been demonstrated to improve tissue oxygenation, microcirculation, renal function and overall outcome of the patient in some studies and literature on actual hemodynamic goals is scarce. ...
متن کاملArterial blood pressure targets in septic shock: is it time to move to an individualized approach?
Xu and colleagues evaluated the impact of increasing mean arterial blood pressure levels through norepinephrine administration on systemic hemodynamics, tissue perfusion, and sublingual microcirculation of septic shock patients with chronic hypertension. The authors concluded that, although increasing arterial blood pressure improved sublingual microcirculation parameters, no concomitant improv...
متن کاملEffect of early fluid resuscitation on the lung in a rat model of lipopolysaccharide-induced septic shock.
BACKGROUND Many clinical trials have showed that early fluid resuscitation can improve the prognosis and reduce the mortality rate of patients with septic shock. However, some experiments suggest that abundant fluid may injure the lung and other tissues. AIM To evaluate the protective effect of early fluid resuscitation and simultaneous norepinephrine treatment on lung function by using the r...
متن کاملA high mean arterial pressure target is associated with improved microcirculation in septic shock patients with previous hypertension: a prospective open label study
INTRODUCTION The effect of mean arterial pressure titration to a higher level on microcirculation in septic shock patients with previous hypertension remains unknown. Our goal is to assess the effect of mean arterial pressure titration to a higher level on microcirculation in hypertensive septic shock patients. METHODS This is a single-center, open-label study. Hypertensive patients with sept...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 3 شماره
صفحات -
تاریخ انتشار 2015