tailieunhanh - Báo cáo y học: "Science Review: Vasopressin and the cardiovascular system part 2 – clinical physiology"

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: Science Review: Vasopressin and the cardiovascular system part 2 – clinical physiology. | Available online http content 8 1 15 Review Science Review Vasopressin and the cardiovascular system part 2 - clinical physiology Cheryl L Holmes1 Donald W Landry2 and John T Granton3 1Staff intensivist Department of Medicine Division of Critical Care Kelowna General Hospital Kelowna BC Canada 2Associate Professor Department of Medicine Columbia University New York New York USA 3Assistant Professor of Medicine Faculty of Medicine and Program Director Critical Care Medicine University of Toronto and Consultant in Pulmonary and Critical Care Medicine Director Pulmonary Hypertension Program University Health Network Toronto Ontario Canada Corresponding author John T Granton Published online 26 June 2003 Critical Care 2004 8 15-23 DOI cc2338 This article is online at http content 8 1 15 2004 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Vasopressin is emerging as a rational therapy for vasodilatory shock states. In part 1 of the review we discussed the structure and function of the various vasopressin receptors. In part 2 we discuss vascular smooth muscle contraction pathways with an emphasis on the effects of vasopressin on ATP-sensitive K channels nitric oxide pathways and interaction with adrenergic agents. We explore the complex and contradictory studies of vasopressin on cardiac inotropy and coronary vascular tone. Finally we summarize the clinical studies of vasopressin in shock states which to date have been relatively small and have focused on physiologic outcomes. Because of potential adverse effects of vasopressin clinical use of vasopressin in vasodilatory shock should await a randomized controlled trial of the effect of vasopressin s effect on outcomes such as organ failure and mortality. Keywords adrenergic agents antidiurectic hormone cardiac inotropy hypotension nitric oxide oxytocin physiology potassium channels receptors septic shock smooth muscle vascular vasoconstriction