[Effect of catecholamines on splanchnic perfusion in sepsis].
Splanchnic ischemia is frequent in sepsis and septic shock and is related to impairment in intestinal permeability, derangement in mucosal barrier functions and translocation of proinflammatory mediators. These changes can contribute to the pathogenesis of multiple organ failure. Vasoactive drugs such as dobutamine and dopexamine can improve splanchnic perfusion and gastric intramucosal pH during sepsis. However, contradictory results have been obtained with dopamine and norepinephrine. On the other hand, epinephrine further impairs splanchnic perfusion. In view of the contradictory effects of different vasoactive drugs, gastric tonometry must be measured during their use, to find the optimal drug combination that optimizes splanchnic blood flow.
Hernández
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Departamento de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Tomicic
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D004298:Dopamine / Q000494:pharmacology*; D006801:Humans; D009638:Norepinephrine / Q000494:pharmacology*; D018805:Sepsis / Q000188:drug therapy / Q000503:physiopathology*; D012772:Shock, Septic / Q000188:drug therapy / Q000503:physiopathology; D013152:Splanchnic Circulation / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
D014662:Vasoconstrictor Agents; D004298:Dopamine; D009638:Norepinephrine