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脓毒性休克早期使用去甲肾上腺素。

Early norepinephrine use in septic shock.

作者信息

Hamzaoui Olfa, Shi Rui

机构信息

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.

出版信息

J Thorac Dis. 2020 Feb;12(Suppl 1):S72-S77. doi: 10.21037/jtd.2019.12.50.

Abstract

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.

摘要

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。

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