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Báo cáo y học: "The International Sepsis Forum’s controversies in sepsis: my initial vasopressor agent in septic shock is norepinephrine rather than dopamine"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài:The International Sepsis Forum’s controversies in sepsis: my initial vasopressor agent in septic shock is norepinephrine rather than dopamine. | Available online http ccforum.eom content 7 1 3 Commentary The International Sepsis Forum s controversies in sepsis my initial vasopressor agent in septic shock is norepinephrine rather than dopamine Vinay K Sharma1 and R Phillip Dellinger2 1 Fellow Critical Care Section Cooper Health System Camden New Jersey USA 2Head Critical Care Section Cooper Health System Camden New Jersey USA Correspondence R Phillip Dellinger dellinger-phil@cooperhealth.edu Published online 1 November 2002 Critical Care 2003 7 3-5 DOI 10.1186 cc1835 This article is online at http ccforum.com content 7 1 3 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X This article is based upon a presentation at the 31st Annual Congress of the Society of Critical Care Medicine SCCM San Diego California USA 26-30 January 2002. The presentation was supported by the International Sepsis Forum ISF . Abstract Vasopressor agents are often used in patients with septic shock when aggressive fluid resuscitation fails to correct hypotension. Dopamine and norepinephrine are two such vasopressor agents. In the past fear of potential excessive vasoconstriction with resultant end-organ hypoperfusion restricted the use of norepinephrine in septic shock relegating it to a second-line agent. However recent data suggest that this relegation is unmerited and that norepinephrine may even be superior to dopamine in some respects and should be considered as the preferred first-line agent. In the present commentary we review the evidence supporting the use of norepinephrine as the agent of choice in the treatment of septic shock. Keywords dopamine norepinephrine septic shock Norepinephrine and dopamine are the common vasopressor agents used in patients in septic shock who do not respond to fluid resuscitation. Norepinephrine is a potent -adrenergic agonist with a weaker but still significant p-adrenergic agonist effect. It increases blood pressure mainly by increasing systemic vascular resistance as a .