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: Cardiovascular and metabolic responses to catecholamine and sepsis prognosis: a ubiquitous phenomenon? | Available online http content 12 2 118 Commentary Cardiovascular and metabolic responses to catecholamine and sepsis prognosis a ubiquitous phenomenon Solène Collin Nacira Sennoun and Bruno Levy Equipe Avenir Inserm Shock Research Group Groupe Choc Nancy Université Faculte de Médecine 54500 Vandoeuvre les Nancy France Corresponding author Bruno Levy Published 17 March 2008 This article is online at http content 12 2 118 2008 BioMed Central Ltd Critical Care 2008 12 118 doi cc6816 See related research by Kumar et al. http content 12 2 R35 Abstract Many parameters have been associated with sepsis prognosis. In the present issue of Critical Care Kumar and colleagues demonstrate that a preserved cardiac answer to dobutamine evaluated by radionucleotide measurements was associated with a better prognosis during septic shock. In this context it is interesting to note that not only is the cardiac response to catecholamine stimulation associated with prognosis but also the vascular and metabolic responses are associated. The ability of exogenous catecholamine to increase the arterial pressure dopamine test or to increase the lactate level is also related to prognosis. According to the ubiquitous character of catecholamine sensitivity therefore we should think in terms of cellular ability to respond to catecholamines in defining the concept of physiological reserve. In the present issue of Critical Care Kumar and colleagues 1 elegantly demonstrate using graded dobutamine challenge in septic shock patients combined with radionucleotide measurement of cardiac function that only the survivors were able to maintain cardiac responsiveness to dobutamine stimulation. In fact the prognosis value of a positive response to dobutamine challenge has been already demonstrated in several studies in which the answer to dobutamine was evaluated using different indices the oxygen delivery oxygen consumption relationship in .
