Preventive Effects of Epinephrine for Critically Ill Patients? More Questions Waiting to Be Answered
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To the Editors,
We read with great interest the paper about the preventive effects of epinephrine on the occurrence of stress ulcer-induced gastrointestinal bleeding in critically ill patients published recently by Becq et al. . In contrary to previous findings, increase usage of epinephrine per day was shown to delay the stress ulcer occurrence among intensive care unit (ICU) patients.
However, we still have some concerns about the study. First, in addition to epinephrine, other vasopressors, such as norepinephrine and dopamine, are also widely used in such populations [2, 3], which might lead to potential bias in assessing epinephrine’s preventive effects, but no data about the associated drug usage were revealed.
Second, stress ulcer-induced gastrointestinal bleeding could be one of the remote organ consequences of acute kidney injury (AKI) or failure among ICU patients . Considering that 60% of enrolled participants received renal replacement therapy, it is natural to...
This work was supported by NSFC Grants (91539118, 81611130092) to C.L., NSFC Grant (81770352) to R.D., NSFC Grant (81473445) to ZG. W., CSC (201703170134) to Y.C., Program of Shanghai Academic Research Leader (17XD1405000), Program for Outstanding Medical Academic Leader (LJRC2015-21), and Shanghai Pilot project for clinical collaboration between TCM and Western Medicine (ZY 2018-2020-FWTX-1102) to C.L.
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Conflict of interest
The authors declare that they have no conflict of interest.
- 3.Joannidis M, Druml W, Forni LG, et al. Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017: expert opinion of the Working Group on Prevention, AKI section, European Society of Intensive Care Medicine. Intensive Care Med. 2017;43:730–749.CrossRefGoogle Scholar