Epinephrine impairs splanchnic perfusion in septic shock

Title

Epinephrine impairs splanchnic perfusion in septic shock

Creator

MeierHellmann A; Reinhart K; Bredle D L; Specht M; Spies C D; Hannemann L

Publisher

Critical Care Medicine

Date

1997
1997-03

Description

Objective: To assess the effects of epinephrine on splanchnic perfusion and splanchnic oxygen uptake in patients with septic shock. Design: Prospective, controlled trial. Setting: University hospital intensive care unit (ICU). Patients: Eight patients with septic shock, according to the criteria of the 1992 American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, requiring treatment with vasopressors. Interventions: We compared in crossover design a 2-hr infusion of epinephrine with dobutamine plus norepinephrine in eight ICU patients with septic shock, Systemic and splanchnic hemodynamics and oxygen transport were measured before and during treatment with epinephrine. Measurements and Main Results: There was essentially no effect of epinephrine on the global parameters, except for increased lactate concentrations, There were marked effects on the regional variables; epinephrine caused lower splanchnic flow and oxygen uptake, lower mucosal pH, and higher hepatic vein lactate. Conclusion: We conclude that undesirable splanchnic effects on patients in whom that region is particularly fragile should be considered when using epinephrine for septic shock treatment.

Subject

sepsis; oxygen consumption; General & Internal Medicine; epinephrine; agents; septic shock; norepinephrine; oxygen delivery; critically ill patients; intramural ph; tissue oxygenation; blood flow; oxygen consumption; gastric-mucosal ph; indocyanine green; splanchnic; splanchnic oxygen delivery; dobutamine; hepatic blood-flow; splanchnic oxygen consumption; vasoactive

Format

Journal Article or Conference Abstract Publication

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

399-404

Issue

3

Volume

25

Citation

MeierHellmann A; Reinhart K; Bredle D L; Specht M; Spies C D; Hannemann L, “Epinephrine impairs splanchnic perfusion in septic shock,” NEOMED Bibliography Database, accessed October 16, 2021, https://neomed.omeka.net/items/show/9092.

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