[Improving tissue perfusion without invasive monitoring. Apropos of a case].
A case is reported of a 64 year old patient who suffered a septic shock after surgical treatment of a biliary peritonitis. Increasing myocardial contractility and aortic blood flow by dobutamine appeared ineffective; added norepinephrine infusion improved the peripheral perfusion. This clinical improvement in tissue perfusion was evaluated by non-invasive continuous monitoring of the haemodynamic profile, combining aortic blood flow measurement by a transoesophageal echo-Doppler and continuous measurement of end-tidal carbon dioxide.
Gueugniaud
P Y
PY
Service d'Anesthésie Réanimation VII, Hôpital Edouard-Herriot, Université Claude-Bernard, Lyon.
Bertin-Maghit
M
M
Bernard
F
F
Muchada
R
R
Petit
P
P
D002245:Carbon Dioxide / Q000032:analysis; D002302:Cardiac Output; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004280:Dobutamine / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004837:Epinephrine / Q000627:therapeutic use; D006801:Humans; D008991:Monitoring, Physiologic; D010101:Oxygen Consumption; D012772:Shock, Septic / Q000503:physiopathology / Q000628:therapy*
D002316:Cardiotonic Agents; D002245:Carbon Dioxide; D004280:Dobutamine; D004837:Epinephrine
Optimisation de la perfusion tissulaire obtenue sans monitorage invasif. A propos d'un cas.