Nash P L
Neonatal Netw. 1990 Jun;8(6):29-34.
Current research suggests that the secretion of beta-endorphin from the pituitary gland may be associated with the refractory hypotension seen in patients with septic shock. Extensive animal research and a few clinical studies have demonstrated that naloxone, a narcotic antagonist, can increase MAP, cardiac output, and cardiac contractility and improve survival in victims of endotoxic shock. The ability of naloxone to improve MAP, however, appears to decrease with prolonged persistent hypotension (greater than eight hours). Studies also suggest that a synergistic effect exists between naloxone and the steroid methylprednisolone in improving the hemodynamics of these patients. In the future, naloxone may prove to be essential in the management of patients in the early stages of septic shock, but more complete clinical trials are warranted. It is imperative that nurses be involved in this type of clinical research.
目前的研究表明，垂体分泌的β-内啡肽可能与脓毒性休克患者出现的难治性低血压有关。大量的动物研究和一些临床研究表明，麻醉拮抗剂纳洛酮可以提高平均动脉压（MAP）、心输出量和心脏收缩力，并提高内毒素休克患者的生存率。然而，随着持续性低血压时间延长（超过8小时），纳洛酮提高MAP的能力似乎会下降。研究还表明，纳洛酮与类固醇甲基强的松龙在改善这些患者的血流动力学方面存在协同作用。未来，纳洛酮可能被证明在脓毒性休克早期患者的管理中至关重要，但需要进行更全面的临床试验。护士参与这类临床研究势在必行。
