Use and Misuse of Catecholamines: Combination in Septic Shock Patients

  • C. Martin
  • X. Viviand
  • F. Potie
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1997)

Abstract

In spite of considerable improvement in monitoring, surgery, antibiotic use, and in­tensive care management of patients, mortality of septic shock patients remains el­evated, sometimes in excess of 60% for the most severe forms [ 1–4]. It is widely ac­cepted that the aim of the treatment is to restore normal values of hemodynamic pa­rameters such as systolic blood pressure ( > 100 mmHg in normotensive subjects) and urine flow ( > 0.7 mL/kg/h). However, the use of such parameters to guide the therapeutic strategy may lead to unsatisfactory results, with still a high mortality [5, 6]. Even the use of hemodynamic parameters obtained from a pulmonary artery catheter does not warrant a significant improvement in survival when these param­eters are restored to normal values [7, 8]. A better approach could be to treat at the same time hemodynamic and oxygen metabolism abnormalities. Thus it is suggest­ed that, in critically ill patients, obtaining and maintaining simultaneously “supranormal” hemodynamic parameters (cardiac index (CI) > 4 L/min/m2) and metabol­ic parameters (oxygen delivery (DO2) > 550 mL/min/m2; oxygen uptake (VO2) > 150 mL/min/m2) could favorably influence survival [9–16].

Keywords

Dopamine Norepinephrine Epinephrine Catecholamine Vasopressin 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • C. Martin
  • X. Viviand
  • F. Potie

There are no affiliations available

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