Vasopressin in vasodilatory shock ensure organ blood flow, but take care of the heart! 英文参考文献.docVIP

Available online /content/10/6/172 Commentary Vasopressin in vasodilatory shock: ensure organ blood flow, but take care of the heart! Martin W Dünser1 and Walter R Hasibeder2 1Department of Intensive Care Medicine, Inselspital Bern, Murtenstrasse, 3010 Bern, Switzerland 2Department of Anesthesiology and Critical Care Medicine, Krankenhaus der Barmherzigen Schwestern, Ried im Innkreis, Austria Corresponding author: Martin W Dünser, Martin.Duenser@uibk.ac.at Published: 22 November 2006 Critical Care 2006, 10:172 (doi:10.1186/cc5089) This article is online at /content/10/6/172 ? 2006 BioMed Central Ltd See related research by Ertmer et al., /content/10/5/R144 Abstract use of AVP in septic shock had been published [3]. Whereas animal experiments (mostly applying AVP as a single vaso- pressor) homogeneously reported a decrease in CI and systemic oxygen transport capacity (DO2I), clinical obser- vations (applying AVP as a supplementary vasopressor) showed heterogeneous responses, with most studies report- ing neutral or even beneficial effects of AVP on cardiac Supplementary arginine vasopressin infusion in advanced vasodilatory shock may be accompanied by a decrease in cardiac index and systemic oxygen transport capacity in approximately 40% of patients. While a reduction of cardiac output most frequently occurs in patients with hyperdynamic circulation, it is less often observed in patients with low cardiac index. Infusion of inotropes, such as dobutamine, may be an effective strategy to performance [2,4]. A recent analysis demonstrated a restore systemic blood flow. However, when administering inotropic drugs, systemic blood flow should be increased to adequately meet systemic demands (assessed by central or mixed venous oxygen saturation) without putting an excessive beta- adrenergic stress on the heart. Overcorrection of