Cardiovascular Management of Septic Shock in 2012

被引:16
作者
Guillamet, Maria Cristina Vazquez [1 ]
Rhee, Chanu [1 ]
Patterson, Andrew J. [1 ]
机构
[1] Stanford Univ, Dept Anesthesia, Div Crit Care Med, Stanford, CA 94040 USA
关键词
Septic shock; Cardiovascular; Capillary leak; Vascular tone; Vascular endothelium; Hypotension; Septic cardiomyopathy; Fluid resuscitation; Vasoactive pharmaceuticals; Vasopressin; V1a receptor agonist; NITRIC-OXIDE SYNTHASE; INADEQUATE ANTIMICROBIAL TREATMENT; PREDICTING FLUID RESPONSIVENESS; GOAL-DIRECTED THERAPY; NF-KAPPA-B; SEVERE SEPSIS; MYOCARDIAL DEPRESSION; TISSUE FACTOR; HYDROXYETHYL STARCH; PULMONARY APOPTOSIS;
D O I
10.1007/s11908-012-0279-z
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Septic shock is a major cause of morbidity and mortality throughout the world. Source control, antimicrobial therapy, early goal-directed fluid resuscitation, and infusion of vasoactive pharmaceuticals remain the cornerstones of treatment. However, the cardiovascular management of septic shock is evolving. Basic science and clinical researchers have identified novel drug targets and are testing the efficacy of new therapeutic agents. For example, prevention of microvascular leak during septic shock is the focus of active investigations and may soon provide considerable benefit to patients. Among the important topics that will be discussed in this review are the following: the role of vascular endothelial dysfunction in microvascular leak, the impact of cytokines upon structural and functional proteins within the endothelial barrier and within the heart, and the ability of selective vasopressin 1a receptor agonists to minimize tissue edema and improve hemodynamic status.
引用
收藏
页码:493 / 502
页数:10
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