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Noradrenaline modif...
Noradrenaline modifies arterial reflection phenomena and left ventricular efficiency in septic shock patients : A prospective observational study
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- Monge Garcia, Manuel Ignacio (author)
- Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain
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- Santos, Arnoldo (author)
- Uppsala universitet,Hedenstiernalaboratoriet,Anestesiologi och intensivvård,CIBER Enfermedades Resp CIBERES, Avd Monforte de Lemos 3-5,Pabellon 11,Planta 0, Madrid 28029, Spain
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- Diez Del Corral, Beatriz (author)
- Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain
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- Guijo Gonzalez, Pedro (author)
- Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain
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- Gracia Romero, Manuel (author)
- Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain
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- Gil Cano, Anselmo (author)
- Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain
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- Cecconi, Maurizio (author)
- St Georges Univ London, London SW17 0QT, England;St Georges Healthcare NHS Trust, Dept Intens Core Med, London SW17 0QT, England
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(creator_code:org_t)
- W B SAUNDERS CO-ELSEVIER INC, 2018
- 2018
- English.
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In: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 47, s. 280-286
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Purpose: To determine whether noradrenaline alters the arterial pressure reflection phenomena in septic shock patients and the effects on left ventricular (LV) efficiency.Material and methods: Thirty-seven septic shock patients with a planned change in noradrenaline dose. Timing and magnitude (Reflection Magnitude and Augmentation Index) of arterial reflections were evaluated. Total, steady, and oscillatory LV power (also expressed as fraction of the total power), subendocardial viability ratio (SEVR), energy efficiency and transmission ratios were used as a marker of LV efficiency.Results: An incremental change in noradrenaline increased Reflection Magnitude [0.28(0.09) to 0.31(0.1], Augmentation Index [-6.4(23.6) to 4.8(20.7)%], and LV total power [0.79(IQR:0.47-1) to 0.98(IQR:0.57-127) W], all p < 0.001; whereas decreased arrival time of reflected waves [from 95(87 to 121) to 83(79 to 101)ms; p < 0.001]. Variables of LV performance showed a decreased efficiency: oscillatory fraction and energy efficiency ratio increased [20.9(5.7) to 22.8(4.9)%, and 82(1.7) to 10.1(2) mW.min.litre(-1); p < 0.001, respectively]; and energy transmission ratio and SEVR decreased [73.8(9.9) to 72(9.8)% and 146(IQR:113-188) to 143 (IQR:109-172)%, p = 0.003 and p = 0.041, respectively].Conclusions: Noradrenaline increased reflection phenomena, increasing LV workload and worsening LV performance in septic shock patients. These conditions could explain the detrimental effects during long-term use of noradrenaline.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Septic shock
- Noradrenaline
- Arterial pressure
- Pulse wave analysis
- Pulse wave velocity
Publication and Content Type
- ref (subject category)
- art (subject category)
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