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Use and Misuse of Catecholamines: Combination in Septic Shock Patients

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine 1997

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1997))

  • 133 Accesses

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].

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Authors
  1. C. Martin
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  2. X. Viviand
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  3. F. Potie
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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© 1997 Springer-Verlag Berlin Heidelberg

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Martin, C., Viviand, X., Potie, F. (1997). Use and Misuse of Catecholamines: Combination in Septic Shock Patients. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1997. Yearbook of Intensive Care and Emergency Medicine, vol 1997. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13450-4_26

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  • DOI: https://doi.org/10.1007/978-3-662-13450-4_26

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-13452-8

  • Online ISBN: 978-3-662-13450-4

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