[Catecholamines: pro and contra]. / Katecholamine: Pro und Kontra.
Med Klin Intensivmed Notfmed
; 111(1): 37-46, 2016 Feb.
Article
em De
| MEDLINE
| ID: mdl-25804726
ABSTRACT
BACKGROUND:
Catecholamines with vasopressor and inotropic effects are commonly used in intensive care medicine. The aim of this review is to explain some of the physiologic actions on which a catecholamine therapy is based, but also to elucidate the risks which are associated with an uncritical and excessive use of these drugs. SIDE EFFECTS Emphasis is placed on the myocardial damage triggered by adrenergic overstimulation. There is considerable evidence that in conditions of severe heart failure, myocardial ischemia as well as cardiogenic and septic shock especially the use of catecholamines with predominant ß-adrenergic effects (epinephrine, dobutamine, dopamine) can have a negative clinical impact. A simple cardiac risk marker might be a tachycardia. ADMINISTRATION Vasopressor therapy with norepinephrine, based on individually applied perfusion parameters (e.g., urine output, lactate), however, seems justified in many conditions of shock and hemodynamic instability during deep analgosedation. In terms of a cardioprotective therapy, the administration of catecholamines, however, should always be reevaluated and titrated to the minimum deemed necessary.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Catecolaminas
/
Cuidados Críticos
Idioma:
De
Ano de publicação:
2016
Tipo de documento:
Article