Abstract |
The hemodynamics of septic shock is characterized by a primary reduction of vascular tone, which defines vasoplegia. Septic vasoplegia is due to reduced endogenous production of vasopressin, as well as to the overproduction of vasodilating molecules ( nitric oxide, prostacyclin, peroxynitrite and kynurenine) and the opening of ATP-sensitive potassium channels. Treatment is supportive and includes primarily alpha- adrenergic catecholamines. Vasopressin may also be useful, although its place is still controversial. Further agents can improve the vascular responsiveness to catecholamines, most notably low doses hydrocortisone, and, to a lesser extent, activated protein C. Further, innovative therapies, based on recent understanding of pathophysiological mechanisms, might become useful agents to treat septic vasoplegia in the future.
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Authors | S Jeanneret, B Sanchez, L Liaudet |
Journal | Revue medicale suisse
(Rev Med Suisse)
Vol. 7
Issue 321
Pg. 2435-8
(Dec 14 2011)
ISSN: 1660-9379 [Print] Switzerland |
Vernacular Title | Physiopathologie et traitement de la vasoplégie au cours du sepsis. |
PMID | 22279861
(Publication Type: English Abstract, Journal Article, Review)
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Chemical References |
- Catecholamines
- KATP Channels
- Prostaglandins I
- Protein C
- Vasopressins
- Peroxynitrous Acid
- Nitric Oxide
- Hydrocortisone
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Topics |
- Catecholamines
(therapeutic use)
- Humans
- Hydrocortisone
(therapeutic use)
- KATP Channels
(metabolism, physiology)
- Models, Biological
- Nitric Oxide
(adverse effects, metabolism, physiology)
- Peroxynitrous Acid
(adverse effects, metabolism, physiology)
- Prostaglandins I
(adverse effects, metabolism, physiology)
- Protein C
(therapeutic use)
- Shock, Septic
(complications, metabolism, therapy)
- Signal Transduction
(physiology)
- Vasoplegia
(etiology, metabolism, therapy)
- Vasopressins
(therapeutic use)
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