Document Detail


Septic shock. Update of treatment using hypertonic saline and antidiuretic hormone-vasopressin.
MedLine Citation:
PMID:  22770759     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Safety in the use of small volumes of hypertonic saline solution for hypovolaemic shock and in the treatment of intracranial hypertension has been demonstrated in studies in the field of resuscitation. There is little experience of this for septic shock in humans. Beneficial immunomodulatory effects have been detected in pre-clinical studies. Interactions with the pituitary-adrenal axis and with the secretion of anti-diuretic hormone are varied and suggestive, but are not sufficiently understood. On the other hand, vasopressin has cardiovascular, osmoregulatory, and coagulation effects, and also acts on the hypothalamic-pituitary-adrenal axis. There is a relative deficit of vasopressin in septic shock. Its use in these patients does seem to have any advantages as regards mortality, but may be beneficial in patients at risk from acute renal failure, or those who receive corticosteroids. Terlipressin is a vasopressin analogue that has also been studied. The synergy between vasopressin and hypertonic saline is a hypothesis that is mainly supported in pre-clinical studies. The use of hypertonic saline solution in septic shock, although promising, is still experimental, and must be restricted to the field of controlled clinical trials.
Authors:
J Pascual-Ramírez; M Aguirre Sánchez-Covisa; F Araujo; S Gil Trujillo; L G Collar; S Bocharán
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-5
Journal Detail:
Title:  Revista espanola de anestesiologia y reanimacion     Volume:  -     ISSN:  0034-9356     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0134516     Medline TA:  Rev Esp Anestesiol Reanim     Country:  -    
Other Details:
Languages:  SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.
Affiliation:
Unidad de Reanimación Postquirúrgica, Hospital General de Ciudad Real, Ciudad Real, España.
Vernacular Title:
Shock séptico. Actualización en tratamiento con suero salino hipertónico y hormona antidiurética-vasopresina.
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