tailieunhanh - Báo cáo y học: "Arginine vasopressin in septic shock: supplement or substitute for norepinephrine"

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: Arginine vasopressin in septic shock: supplement or substitute for norepinephrine? | Available online http content 13 4 178 Commentary Arginine vasopressin in septic shock supplement or substitute for norepinephrine Sebastian Rehberg1 2 Perenlei Enkhbaatar1 and Daniel L Traber1 investigational Intensive Care Unit Department of Anesthesiology The University of Texas Medical Branch 301 University Blvd Galveston TX 77555 USA 2Department of Anesthesiology and Intensive Care University of Muenster Albert-Schweitzer-Str. 33 48149 Muenster Germany Corresponding author Sebastian Rehberg serehber@ Published 14 August 2009 This article is online at http content 13 4 178 2009 BioMed Central Ltd Critical Care 2009 13 178 doi cc7985 See related research by Simon et al. http content 13 4 R113 Abstract In the current issue of Critical Care Simon and coworkers investigated the effects of first-line arginine vasopressin AVP on organ function and systemic metabolism compared with norepinephrine in a pig model of fecal peritonitis. AVP was titrated according to the mean arterial pressure suggesting a vasopressor rather than a hormone replacement therapy. The study provides some evidence for the safety of this therapeutic approach. It needs to be determined whether AVP is most beneficial as a constant low-dose infusion to supplement norepinephrine or in higher doses than currently recommended to substitute norepinephrine. In addition future studies are warranted to evaluate whether a first-line therapy of AVP is superior to a last-resort administration. In the current issue of Critical Care Simon and coworkers carefully investigated the effects of arginine vasopressin AVP on myocardial hepatic and renal function as well as on systemic metabolism compared with norepinephrine in a pig model of fecal peritonitis 1 . Both compounds were titrated to keep the mean arterial pressure MAP at baseline values. Maximum doses were limited to 5 ng kg min for AVP equivalent to IU min in a 70 kg patient and to norepinephrine .