Corrêa Thiago Domingos, Filho Roberto Rabello, Assunção Murillo Santucci Cesar, Silva Eliézer, Lima Alexandre
*Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil †Department of Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Shock. 2017 Mar;47(3):269-275. doi: 10.1097/SHK.0000000000000777.
Microcirculatory abnormalities have been shown to be frequent in patients with septic shock despite "normalization" of systemic hemodynamics. Several studies have explored the impact of vasodilator therapy (prostacyclin, inhaled nitric oxide, topic acetylcholine, and nitroglycerin) on microcirculation and tissue perfusion, with contradictory findings.In this narrative review, we briefly present the pathophysiological aspects of microcirculatory dysfunction, and depict the evidence supporting the use of vasodilators and other therapeutic interventions (fluid administration, blood transfusion, vasopressors, and dobutamine) aiming to improve the microcirculatory flow in septic shock patients.
尽管全身血流动力学已“正常化”，但微循环异常在感染性休克患者中仍很常见。多项研究探讨了血管扩张剂治疗（前列环素、吸入一氧化氮、局部乙酰胆碱和硝酸甘油）对微循环和组织灌注的影响，结果相互矛盾。在这篇叙述性综述中，我们简要介绍了微循环功能障碍的病理生理学方面，并描述了支持使用血管扩张剂和其他治疗干预措施（液体输注、输血、血管升压药和多巴酚丁胺）以改善感染性休克患者微循环血流的证据。
