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Báo cáo khoa học: " Clinical review: Immunomodulatory effects of dopamine in general inflammation"

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: Clinical review: Immunomodulatory effects of dopamine in general inflammation. | Available online http ccforum.eom content 8 6 485 Review Clinical review Immunomodulatory effects of dopamine in general inflammation Grietje Ch Beck1 Paul Brinkkoetter2 Christine Hanusch1 Jutta Schulte1 Klaus van Ackern3 Fokko J van der Woude4 and Benito A Yard2 11nstitute of Anaesthesiology University of Mannheim Mannheim Germany 2V Medical Clinic University of Mannheim Mannheim Germany 3Professor Director Institute of Anaesthesiology University of Mannheim Mannheim Germany 4Professor Director V Medical Clinic University of Mannheim Mannheim Germany Corresponding author Grietje Beck grietje.beck@anaes.ma.uni-heidelberg.de Published online 3 June 2004 This article is online at http ccforum.com content 8 6 485 2004 BioMed Central Ltd Critical Care 2004 8 485-491 DOI 10.1186 cc2879 Abstract Large quantitaties of inflammatory mediators are released during the course of endotoxaemia. These mediators in turn can stimulate the sympathetic nervous system SNS to release catecholamines which ultimately regulate inflammation-associated impairment in tissue perfusion myocardial impairment and vasodilatation. Treatment of sepsis is based on surgical and or antibiotic therapy appropriate fluid management and application of vasoactive catecholamines. With respect to the latter discussions on the vasopressor of choice are ongoing. Over the past decade dopamine has been considered the first line vasopressor and is frequently used to improve organ perfusion and blood pressure. However a growing body of evidence indicates that dopamine has deleterious side effects therefore its clinical relevance seems to be more and more questionable. Nevertheless it has not been convincingly demonstrated that other catecholamines are superior to dopamine in this respect. Apart from its haemodynamic action dopamine can modulate immune responses by influencing the cytokine network. This leads to inhibition of expression of adhesion molecules inhibition of cytokine and chemokine production .