lunes, 12 de enero de 2015

Shock

No.1849                                                                                   12 de enero 2015

Nuevo portal / New website

Ya pueden visitar nuestro nuevo portal anestesia-dolor.org. Seguiremos trabajando por una mejor educación virtual.
You can now visit our new website anestesia-dolor.org . We will continue working for a better virtual education.
Infusión de isoproterenol y microcirculación en shock séptico 
Isoproterenol infusion and microcirculation in septic shock.
Wiramus S, Textoris J, Bardin R, Vigne C, Kelway C, Martin C, Leone M.
Heart Lung Vessel. 2014;6(4):274-9.
Abstract
INTRODUCTION: Our study primarily aimed at investigating the effect of isoproterenol infusion on tissue oxygen saturation in patients with septic shock. The secondary aim was to assess the relation between cardiac index, central venous oxygen saturation and tissue oxygen saturation. METHODS: This retrospective study was conducted from December 2010 to March 2012. We included 14 consecutive patients with septic shocktreated with isoproterenol. All patients were monitored by cardiac index and tissue oxygen saturation. From medical charts, routine hemodynamic data were extracted one hour before and six hours after the onset of isoproterenol infusion. RESULTS: From baseline to H6, tissue oxygen saturation levels rise from 78 [72-82]% to 85 [78-88]% (p = 0.03). Isoproterenol infusion was associated with an increase of central venous oxygen saturation (from 67 [65-74]% to 84 [77-86]%, p = 0.02) and cardiac index (from 2.9 [2.7-3.1] L/min/m² to 3.9 [3.0-4.4] L/min/m², p = 0.006). Tissue oxygen saturation was correlated neither to cardiac index (p = 0.14, R(2) = 0.08) nor to central venous oxygen saturation (p = 0.19, R(2) = 0.10). CONCLUSIONS: Use of isoproterenol was associated with an increase of tissue oxygen saturation. This increase was not correlated to cardiac index, suggesting a decoupling between macrocirculation and microcirculation.
KEYWORDS: isoproterenol; microcirculation; oxygen saturation; septic shock
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