Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Early administration of norepinephrine increases cardiac preload and cardiac output in septic patients with life-threatening hypotension. | Hamzaoui et al. Critical Care 2010 14 R142 http content 14 4 R142 c CRITICAL CARE RESEARCH Open Access Early administration of norepinephrine increases cardiac preload and cardiac output in septic patients with life-threatening hypotension Olfa Hamzaoui Jean-Frangois Georger Xavier Monnet Hatem Ksouri Julien Maizel Christian Richard Jean-Louis Teboul Abstract Introduction We sought to examine the cardiac consequences of early administration of norepinephrine in severely hypotensive sepsis patients hospitalized in a medical intensive care unit of a university hospital. Methods We included 105 septic-shock patients who already had received volume resuscitation. All received norepinephrine early because of life-threatening hypotension and the need to achieve a sufficient perfusion pressure rapidly and to maintain adequate flow. We analyzed the changes in transpulmonary thermodilution variables associated with the increase in mean arterial pressure MAP induced by norepinephrine when the achieved MAP was 65 mm Hg. Results Norepinephrine significantly increased MAP from 54 8 to 76 9 mm Hg cardiac index CI from to L min m2 stroke volume index SVI from 34 12 to 39 13 ml m2 global end-diastolic volume index GEDVI from 694 148 to 742 168 ml m2 and cardiac function index CFI from to per min. Beneficial hemodynamic effects on CI SVI GEDVI and CFI were observed in the group of 71 patients with a baseline echocardiographic left ventricular ejection fraction LVEF 45 as well as in the group of 34 patients with a baseline LVEF 45 . No change in CI SVI GEDVI or CFI was observed in the 17 patients with baseline LVEF 45 for whom values of MAP 75 mm Hg were achieved with norepinephrine. Conclusions Early administration of norepinephrine aimed at rapidly achieving a sufficient perfusion pressure in severely hypotensive septic-shock patients is able to increase cardiac output through an increase in cardiac preload and cardiac contractility. .
