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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Myocardial protection in sepsis. | Available online http ccforum.eom content 12 5 177 Commentary Myocardial protection in sepsis Simon Shakar and Brian D Lowes Division of Cardiology University of Colorado Denver Aurora CO 80045 USA Corresponding author Simon Shakar Simon.Shakar@UCHSC.edu Published 3 September 2008 This article is online at http ecforum.eom eontent 12 5 177 2008 BioMed Central Ltd Critical Care 2008 12 177 doi 10.1186 cc6978 See related research by Schmittinger et al. http ccforum.com content 12 4 R99 Abstract Sepsis with myocardial dysfunction is seen commonly. Betablockers have been used successfully to treat chronic heart failure based on the premise that chronically elevated adrenergic drive is detrimental to the myocardium. However recent reports on the acute use of beta-blockers in situations with potential hemodynamic compromise have shown the risks associated with this approach. In critical situations the main effect of adrenergic activation is to support cardiovascular function. Caution should be exercised in designing studies to assess beta-blockers in septic patients. Can p-blockers improve outcomes in septic patients with myocardial depression In the previous issue of Critical Care Schmittinger and colleagues 1 discuss the results of treating myocardial depression in septic shock patients with the combination of milrinone and metoprolol. They report on a retrospective cohort of 40 patients. All were intubated and 70 were dialyzed. Support included volume infusion treatment with milrinone a phosphodiesterase inhibitor and rapid addition of norepinephrine then vasopressin 31 of 40 patients based on hemodynamic measurements. Metoprolol a p1-selective adrenergic antagonist was given enterally at low doses 25 to 47.5 mg day . Over 96 hours of follow-up inotropic and vasopressor doses decreased heart rate decreased and cardiac output remained stable. Lactate pH creatinine and C-reactive protein improved. The study limitations are noted by the authors. Specifically on .
