Erschienen in:
01.04.2014 | Year in Review 2013
Year in review in Intensive Care Medicine 2013: III. Sepsis, infections, respiratory diseases, pediatrics
verfasst von:
Jean-Francois Timsit, Giuseppe Citerio, Jan Bakker, Matteo Bassetti, Dominique Benoit, Maurizio Cecconi, J. Randall Curtis, Glenn Hernandez, Margaret Herridge, Samir Jaber, Michael Joannidis, Laurent Papazian, Mark Peters, Pierre Singer, Martin Smith, Marcio Soares, Antoni Torres, Antoine Vieillard-Baron, Elie Azoulay
Erschienen in:
Intensive Care Medicine
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Ausgabe 4/2014
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Excerpt
Dobutamine has been widely advocated to improve (inadequate) cardiac output in septic shock. However, on the basis of the double-blind, crossover, randomized study from Hernandez et al. [
1], the microcirculatory and regional effects, despite improvement of the macrocirculation, seem to be limited. Indeed despite an increase in cardiac output and heart rate, with dobutamine, they found no significant impact on lactate level and sublingual vessel perfused density. This is in contrast to some other studies. The question now is were the results of these earlier studies wrong or is the current baseline resuscitation of critically ill patients so different from these earlier days that the state of the vasculature of our patients is now different when compared to those earlier days? …