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脓毒性休克中儿茶酚胺的选择:越来越多有力论据支持现有观点,但不要丧失信心!

The choice of catecholamines in septic shock: more and more good arguments to strengthen the known position, but don't lose the faith!

作者信息

Meier-Hellmann Andreas

机构信息

Department of Anesthesiology, Intensive Care Medicine and Pain Management, HELIOS Klinikum Erfurt GmbH, Erfurt, Germany.

出版信息

Crit Care. 2006;10(2):127. doi: 10.1186/cc4859.

Abstract

The choice of catecholamines for hemodynamic stabilisation in septic shock patients has been an ongoing debate for several years. Several studies have investigated the regional effects in septic patients. Because of an often very small sample size, because of inconsistent results and because of methodical problems in the monitoring techniques used in these studies, however, it is not possible to provide clear recommendations concerning the use of catecholamines in sepsis. Prospective and adequate-sized studies are necessary because outcome data are completely lacking.

摘要

对于感染性休克患者血流动力学稳定时儿茶酚胺的选择,多年来一直存在争议。多项研究调查了感染患者的局部效应。然而,由于这些研究的样本量往往非常小、结果不一致以及所采用监测技术存在方法学问题,因此无法就脓毒症中儿茶酚胺的使用给出明确建议。由于完全缺乏结局数据,开展前瞻性且样本量充足的研究很有必要。

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本文引用的文献

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Effects of dopamine and epinephrine infusions on renal hemodynamics in severe malaria and severe sepsis.
Crit Care Med. 2000 May;28(5):1353-62. doi: 10.1097/00003246-200005000-00016.
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Epinephrine impairs splanchnic perfusion in septic shock.肾上腺素会损害感染性休克中的内脏灌注。
Crit Care Med. 1997 Mar;25(3):399-404. doi: 10.1097/00003246-199703000-00005.
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Regional blood flow and oxygen transport in septic shock.脓毒性休克时的局部血流与氧输送
Crit Care Med. 1993 Sep;21(9):1296-303. doi: 10.1097/00003246-199309000-00011.

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