Thoracic epidural anesthesia in sepsis – is it harmful or protective 英文参考文献.docVIP

Available online /content/13/5/182 Commentary Thoracic epidural anesthesia in sepsis - is it harmful or protective? Christian Mutz1,2 and Dierk A Vagts1,2 1Department of Anaesthesiology and Intensive Care Medicine, Hetzelstift Hospital Neustadt/ Weinstrasse, Stiftstrasse 10, D-67434 Neustadt/Weinstrasse, Germany 2Department of Anaesthesiology and Intensive Care Medicine, University of Rostock, Schillingallee 35, D-18057 Rostock, Germany Corresponding author: Dierk A Vagts, dierk.vagts@uni-rostock.de Published: 16 September 2009 Critical Care 2009, 13:182 (doi:10.1186/cc8015) This article is online at /content/13/5/182 ? 2009 BioMed Central Ltd See related research by Freise et al., /content/13/4/R116, and Lauer et al., /content/13/4/R109 Abstract in an additional group of animals, which were not investigated with intravital microscopy - remained constant in animals with induced sepsis with and without epidural anesthesia. From Research interest in epidural anesthesia during sepsis has grown over the past years and studies have tried to determine its mecha- nisms, which should, theoretically, protect organs and reduce morbidity and mortality. However, different experimental approaches in different animal models have provided conflicting results over whether epidural anesthesia has protective or harmful effects and whether these alter depending on the phase of sepsis, the spread of epidural anesthesia or additional supportive therapies. In the future, more standardized research is necessary to integrate the results of all studies, which have been published. their intravital microscopy results they concluded that sinusoidal blood flow increased in the sepsis group and was normalized in the group with sepsis and thoracic epidural anesthesia. However, sinusoidal vasoconstriction was not ameliorated by thoracic epidural anesthesia and nor was liver tissue injury affected. Lauer