Cardiovascular and metabolic responses to catecholamine and sepsis prognosis: a ubiquitous phenomenon?

• Published in: Critical care (London, England) England), 2008-01, Vol.12 (2), p.118-118
• Main Authors: Collin, Solène, Sennoun, Nacira, Levy, Bruno
• Format: Article
• Language: English
• Subjects: Aged; Cardiac Output - drug effects; Cardiac Output - physiology; Cardiotonic Agents - administration & dosage; Dobutamine - administration & dosage; Female; Heart Rate - drug effects; Heart Rate - physiology; Hemodynamics - drug effects; Humans; Male; Middle Aged; Predictive Value of Tests; Prognosis; Radiopharmaceuticals; Sepsis - mortality; Sepsis - physiopathology; Shock, Septic - mortality; Shock, Septic - physiopathology; Survival Analysis; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Pentetate; Vascular Resistance - drug effects; Vascular Resistance - physiology; Ventricular Function, Left - drug effects; Ventricular Function, Left - physiology
• ISSN: 1364-8535; 1466-609X
• DOI: 10.1186/cc6816

Many parameters have been associated with sepsis prognosis. In the present issue of Critical Care, Kumar and colleagues demonstrate that a preserved cardiac answer to dobutamine evaluated by radionucleotide measurements was associated with a better prognosis during septic shock. In this context, it is interesting to note that not only is the cardiac response to catecholamine stimulation associated with prognosis, but also the vascular and metabolic responses are associated. The ability of exogenous catecholamine to increase the arterial pressure (dopamine test) or to increase the lactate level is also related to prognosis. According to the ubiquitous character of catecholamine sensitivity, therefore, we should think in terms of cellular ability to respond to catecholamines in defining the concept of physiological reserve.