tailieunhanh - Báo cáo y học: "Levosimendan for resuscitating the microcirculation in patients with septic shock: a randomized controlled study"

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: Levosimendan for resuscitating the microcirculation in patients with septic shock: a randomized controlled study. | Morelli et al. Critical Care 2010 14 R232 http content 14 6 R232 KS CRITICAL CARE RESEARCH Open Access Levosimendan for resuscitating the microcirculation in patients with septic shock a randomized controlled study 1 2 3 3 3 1 Andrea Morelli Abele Donati Christian Ertmer Sebastian Rehberg Matthias Lange Alessandra Orecchioni 2lorÌ2 r ini1 fOir iXỉdnni I ndnni4 DoItỉÍtỉ2 Dioi rr ir i r tli1 I Il ir ir 1 n Alzon3 Icori-I r i lie Tohni 5 Valeria Cecchini Giovanni Landoni Paolo Pelaia Paolo Pietiopaoli Hugo Van Aken Jean Louis Teboul Can Ince6 7 Martin Westphal3 Abstract Introduction The purpose of the present study was to investigate microcirculatory blood flow in patients with septic shock treated with levosimendan as compared to an active comparator drug . dobutamine . The primary end point was a difference of 20 in the microvascular flow index of small vessels MFIs among groups. Methods The study was designed as a prospective randomized double-blind clinical trial and performed in a multidisciplinary intensive care unit. After achieving normovolemia and a mean arterial pressure of at least 65 mmHg 40 septic shock patients were randomized to receive either levosimendan pg-kg-1-min-1 n 20 or an active comparator dobutamine 5 pg-kg-1-min-1 control n 20 for 24 hours. Sublingual microcirculatory blood flow of small and medium vessels was assessed by sidestream dark-field imaging. Microcirculatory variables and data from right heart catheterization were obtained at baseline and 24 hours after randomization. Baseline and demographic data were compared by means of Mann-Whitney rank sum test or chi-square test as appropriate. Microvascular and hemodynamic variables were analyzed using the Mann-Whitney rank sum test. Results Microcirculatory flow indices of small and medium vessels increased over time and were significantly higher in the levosimendan group as compared to the control group 24 hrs MFIm vs. P .02 MFIs vs. .

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