Cardiovascular and metabolic responses to catecholamine and sepsis prognosis: a ubiquitous phenomenon?
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.
Collin
Solène
S
Equipe Avenir Inserm, Shock Research Group (Groupe Choc), Nancy Université, Faculté de Médecine, 54500 Vandoeuvre les Nancy, France.
Sennoun
Nacira
N
Levy
Bruno
B
D000368:Aged; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D004280:Dobutamine / Q000008:administration & dosage*; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D018805:Sepsis / Q000401:mortality / Q000503:physiopathology*; D012772:Shock, Septic / Q000401:mortality / Q000503:physiopathology*; D016019:Survival Analysis; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
D002316:Cardiotonic Agents; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C057162:technetium Tc 99m DTPA HSA; D004280:Dobutamine; D016284:Technetium Tc 99m Pentetate