Isoproterenol for the Treatment of Circulatory Shock

1969 ◽  
Vol 70 (3) ◽  
pp. 638 ◽  
Author(s):  
MAX HARRY WEIL
Keyword(s):  
Circulatory Shock

scholarly journals H2S in acute lung injury: a therapeutic dead end(?)

2020 ◽  
Vol 8 (S1) ◽  
Author(s):  
Tamara Merz ◽  
Nicole Denoix ◽  
Martin Wepler ◽  
Holger Gäßler ◽  
David A. C. Messerer ◽  
...  
Keyword(s):  
Hydrogen Sulfide ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Circulatory Shock ◽  
Therapeutic Window ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Clinical Reality ◽  
Dead End

AbstractThis review addresses the plausibility of hydrogen sulfide (H2S) therapy for acute lung injury (ALI) and circulatory shock, by contrasting the promising preclinical results to the present clinical reality. The review discusses how the narrow therapeutic window and width, and potentially toxic effects, the route, dosing, and timing of administration all have to be balanced out very carefully. The development of standardized methods to determine in vitro and in vivo H2S concentrations, and the pharmacokinetics and pharmacodynamics of H2S-releasing compounds is a necessity to facilitate the safety of H2S-based therapies. We suggest the potential of exploiting already clinically approved compounds, which are known or unknown H2S donors, as a surrogate strategy.

Endothelial Dysfunction in Shock States

Physiology ◽  
1993 ◽  
Vol 8 (4) ◽  
pp. 145-148 ◽  
Author(s):  
AGB Kovach ◽  
AM Lefer
Keyword(s):  
Nitric Oxide ◽  
Endothelial Dysfunction ◽  
Tissue Injury ◽  
Circulatory Shock ◽  
Relaxing Factor ◽  
Vascular Beds ◽  
Endothelium Derived Relaxing Factor

Circulatory shock results in dysfunction of the endothelium in various vascular beds. This dysfunction is characterized by marked impairment in the vasculature's ability to relax to endothelium-dependent vasodilators. This loss of endothelium-derived relaxing factor, or nitric oxide, leads to profound tissue injury.

scholarly journals Noradrenaline versus Dopamine in the Treatment of Circulatory Shock

2010 ◽  
Vol 11 (4) ◽  
pp. 272-274
Author(s):  
Hozefa Ebrahim ◽  
Tomasz Torlinski
Keyword(s):  
Circulatory Shock

scholarly journals Target arterial PO2 according to the underlying pathology: a mini-review of the available data in mechanically ventilated patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julien Demiselle ◽  
Enrico Calzia ◽  
Clair Hartmann ◽  
David Alexander Christian Messerer ◽  
Pierre Asfar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Large Scale ◽  
Retrospective Studies ◽  
Prolonged Exposure ◽  
Oxygen Toxicity ◽  
Circulatory Shock ◽  
Mechanically Ventilated ◽  
Ischaemia Reperfusion ◽  
Arterial Po2 ◽  
Underlying Pathology

AbstractThere is an ongoing discussion whether hyperoxia, i.e. ventilation with high inspiratory O2 concentrations (FIO2), and the consecutive hyperoxaemia, i.e. supraphysiological arterial O2 tensions (PaO2), have a place during the acute management of circulatory shock. This concept is based on experimental evidence that hyperoxaemia may contribute to the compensation of the imbalance between O2 supply and requirements. However, despite still being common practice, its use is limited due to possible oxygen toxicity resulting from the increased formation of reactive oxygen species (ROS) limits, especially under conditions of ischaemia/reperfusion. Several studies have reported that there is a U-shaped relation between PaO2 and mortality/morbidity in ICU patients. Interestingly, these mostly retrospective studies found that the lowest mortality coincided with PaO2 ~ 150 mmHg during the first 24 h of ICU stay, i.e. supraphysiological PaO2 levels. Most of the recent large-scale retrospective analyses studied general ICU populations, but there are major differences according to the underlying pathology studied as well as whether medical or surgical patients are concerned. Therefore, as far as possible from the data reported, we focus on the need of mechanical ventilation as well as the distinction between the absence or presence of circulatory shock. There seems to be no ideal target PaO2 except for avoiding prolonged exposure (> 24 h) to either hypoxaemia (PaO2 < 55–60 mmHg) or supraphysiological (PaO2 > 100 mmHg). Moreover, the need for mechanical ventilation, absence or presence of circulatory shock and/or the aetiology of tissue dysoxia, i.e. whether it is mainly due to impaired macro- and/or microcirculatory O2 transport and/or disturbed cellular O2 utilization, may determine whether any degree of hyperoxaemia causes deleterious side effects.

Mechanism of circulatory shock induced by monoclonal antibody against neutrophils

1994 ◽  
Vol 1 ◽  
pp. 212
Author(s):  
I. Shiraishi ◽  
EF. Sato ◽  
M. Nishikawa ◽  
F. Sendo ◽  
M. Inoue
Keyword(s):  
Monoclonal Antibody ◽  
Circulatory Shock

Circulatory shock in pregnant sheep

1972 ◽  
Vol 112 (8) ◽  
pp. 1084-1094 ◽  
Author(s):  
P. Bech-Jansen ◽  
C.R. Brinkman ◽  
G.H. Johnson ◽  
N.S. Assali
Keyword(s):  
Circulatory Shock ◽  
Pregnant Sheep

THE ROLE OF INFLAMMATORY CELLS IN THE DEVELOPMENT OF CIRCULATORY SHOCK ELICITED BY THE REPERFUSION INJURY OF THE SMALL INTESTINE.

Shock ◽  
1994 ◽  
Vol 2 (Supplement) ◽  
pp. 28
Author(s):  
J. Hamar ◽  
G. Illyés ◽  
G. Gösi ◽  
L. Vimláti ◽  
I. B. Rácz ◽  
...  
Keyword(s):  
Small Intestine ◽  
Reperfusion Injury ◽  
Inflammatory Cells ◽  
Circulatory Shock

scholarly journals Current use of inotropes in circulatory shock

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thomas W. L. Scheeren ◽  
Jan Bakker ◽  
Thomas Kaufmann ◽  
Djillali Annane ◽  
Pierre Asfar ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Additional Treatment ◽  
Circulatory Shock ◽  
Left Ventricular Ejection ◽  
First Line ◽  
Ventricular Ejection Fraction

Abstract Background Treatment decisions on critically ill patients with circulatory shock lack consensus. In an international survey, we aimed to evaluate the indications, current practice, and therapeutic goals of inotrope therapy in the treatment of patients with circulatory shock. Methods From November 2016 to April 2017, an anonymous web-based survey on the use of cardiovascular drugs was accessible to members of the European Society of Intensive Care Medicine (ESICM). A total of 14 questions focused on the profile of respondents, the triggering factors, first-line choice, dosing, timing, targets, additional treatment strategy, and suggested effect of inotropes. In addition, a group of 42 international ESICM experts was asked to formulate recommendations for the use of inotropes based on 11 questions. Results A total of 839 physicians from 82 countries responded. Dobutamine was the first-line inotrope in critically ill patients with acute heart failure for 84% of respondents. Two-thirds of respondents (66%) stated to use inotropes when there were persistent clinical signs of hypoperfusion or persistent hyperlactatemia despite a supposed adequate use of fluids and vasopressors, with (44%) or without (22%) the context of low left ventricular ejection fraction. Nearly half (44%) of respondents stated an adequate cardiac output as target for inotropic treatment. The experts agreed on 11 strong recommendations, all of which were based on excellent (> 90%) or good (81–90%) agreement. Recommendations include the indications for inotropes (septic and cardiogenic shock), the choice of drugs (dobutamine, not dopamine), the triggers (low cardiac output and clinical signs of hypoperfusion) and targets (adequate cardiac output) and stopping criteria (adverse effects and clinical improvement). Conclusion Inotrope use in critically ill patients is quite heterogeneous as self-reported by individual caregivers. Eleven strong recommendations on the indications, choice, triggers and targets for the use of inotropes are given by international experts. Future studies should focus on consistent indications for inotrope use and implementation into a guideline for circulatory shock that encompasses individualized targets and outcomes.

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