Hamzaoui Olfa, Shi Rui
Service de réanimation polyvalente, Hôpital Antoine Béclère, AP-HP, Hôpitaux universitaires Paris-Sud, Clamart, France.
INSERM-UMR_S999 LabEx - LERMIT, Hôpital Marie-Lannelongue, Le Plessis Robinson, France.
J Thorac Dis. 2020 Feb;12(Suppl 1):S72-S77. doi: 10.21037/jtd.2019.12.50.
As vascular tone depression is a hallmark of septic shock, administration of norepinephrine is logical in this setting. In this article, we provide and develop the following arguments for an early use of norepinephrine-the recommended first-line vasopressor-in septic shock: (I) prevention of prolonged severe hypotension, (II) increase in cardiac output through an increase in cardiac preload and/or contractility, (III) improvement of microcirculation and tissue oxygenation, (IV) prevention of fluid overload, and (V) improvement of outcome. Presence of a low diastolic arterial pressure as a marker of depressed vascular tone can be used as a trigger to initiate norepinephrine urgently.
由于血管张力降低是感染性休克的一个标志，在此情况下使用去甲肾上腺素是合理的。在本文中，我们提出并阐述了以下支持在感染性休克中早期使用去甲肾上腺素（推荐的一线血管升压药）的观点：（I）预防长时间严重低血压；（II）通过增加心脏前负荷和/或收缩力来增加心输出量；（III）改善微循环和组织氧合；（IV）预防液体超负荷；（V）改善预后。低舒张压作为血管张力降低的一个标志，可作为紧急启动去甲肾上腺素治疗的触发因素。
