| A reappraisal of isoproterenol in goal-directed therapy of septic shock. | |
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MedLine Citation:
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PMID: 16980881 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The goal of the study was to evaluate the effect of isoproterenol prescribed in goal-directed therapy for septic shock. Out of a cohort of 89 patients with septic shock, 14 patients treated with fluid and norepinephrine had inappropriate mixed venous oxygen saturation (SvO2<70%) not responding to correction of hypoxemia and anemia (>8 g.dL-1). Isoproterenol administration was started at a dose of 0.04 microg.kg-1.minute-1 with 0.025 microg.kg-1.minute-1 increments every 30 minutes until SvO2 was greater than 70%. Mean arterial pressure was maintained>or=65 mm.Hg by adjusting the norepinephrine infusion. Hemodynamic, oxygen, and renal variables were collected during a 12-h period. Patients with a known prior history of coronary disease were not eligible. Isoproterenol administration increased significantly SvO2 (62%+/-10% to 71%+/-9%), cardiac index (3.1+/-0.6 to 4.4+/-1.4 L.min-1.m-2), stroke index (27+/-3.4 to 38+/-6.1 mL.m-2), and left ventricular stroke work index (24+/-3.4 to 40+/-5.0 g.m-1.m-2). Heart rate rise did not reach a significant level. Arterial lactate concentration decreased significantly during the study period (5.7+/-2.8 to 3.4+/-1.6 mmol.L-1). No cardiac adverse events occurred with any electrocardiographic aspects of myocardial ischemia. This study suggests that isoproterenol is efficient to improve hemodynamics and oxygen variables in septic shock patients. There is a need for future investigations in larger groups of patients to determine whether isoproterenol can be an alternative to dobutamine. |
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Authors:
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Marc Leone; Ioanna Boyadjiev; Emile Boulos; Francois Antonini; Pierre Visintini; Jacques Albanèse; Claude Martin |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Shock (Augusta, Ga.) Volume: 26 ISSN: 1073-2322 ISO Abbreviation: Shock Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-09-18 Completed Date: 2006-12-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9421564 Medline TA: Shock Country: United States |
Other Details:
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Languages: eng Pagination: 353-7 Citation Subset: IM |
Affiliation:
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Département d'Anesthésie et de Réanimation, UPRES Equipe d'Accueil 3784, Centre Hospitalier Universitaire Nord, 13915 Marseille cedex 20, France. marc.leone@ap-hm.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Agonists
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pharmacology* Adult Aged Female Humans Isoproterenol / pharmacology* Male Middle Aged Shock, Septic / drug therapy*, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Agonists; 7683-59-2/Isoproterenol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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