tailieunhanh - Báo cáo y học: "Vasopressin and ischaemic heart disease: more than coronary"

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 ngành y học đề tài: Vasopressin and ischaemic heart disease: more than coronary . | Available online http content 13 4 169 Commentary Vasopressin and ischaemic heart disease more than coronary vasoconstriction Pierre Asfar1 and Peter Radermacher2 1 Laboratoire HIFIH UPRES-EA 3859 IFR 132 Université d Angers Département de Réanimation Médicale et Médecine Hyperbare Centre Hospitalier Universitaire 49933 Angers Cedex 09 France 2Sektion Anasthesiologische Pathophysiologie und Verfahrensentwicklung Klinik fur Anasthesiologie Universitatsklinikum Parkstrasse 11 89073 Ulm Germany Corresponding author Professor Pierre Asfar piasfar@ Published 22 July 2009 This article is online at http content 13 4 169 2009 BioMed Central Ltd Critical Care 2009 13 169 doi cc7954 See related research by Indrambarya et al. http content 13 3 R98 Abstract During advanced vasodilatory shock arginine vasopressin AVP is increasingly used to restore blood pressure and thus to reduce catecholamine requirements. The AVP-related rise in mean arterial pressure is due to systemic vasoconstriction which depending on the infusion rate may also reduce coronary blood flow despite an increased coronary perfusion pressure. In a murine model of myocardial ischaemia Indrambarya and colleagues now report that a 3-day infusion of AVP decreased the left ventricular ejection fraction ultimately resulting in increased mortality and thus compared unfavourably with a standard treatment using dobutamine. The AVP-related impairment myocardial dysfunction did not result from the increased left ventricular afterload but from a direct effect on cardiac contractility. Consequently the authors conclude that the use of AVP should be cautioned in patients with underlying cardiac disease. In the previous issue of Critical Care Indrambarya and colleagues compared a 72-hour infusion of arginine vasopressin AVP infusion rate equivalent to IU min in a 70 kg human being dobutamine j-Lg kg min and vehicle in mice that had undergone myocardial .