Norepinephrine therapy has no deleterious renal effects in human septic shock

Desjars, P; Pinaud, M.; Bugnon, Denis; Tasseau, F.

doi:10.1097/00003246-198905000-00010

Cited by 185 publications

(57 citation statements)

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“…Several observational studies show that noradrenaline is the vasoconstrictive agent of choice, which combines the best compromise in term of cost, safety and ease of use [111][112][113][114][115][116][117]. There is no controlled study concerning this specific point.…”

Section: (Grade 2+) Strong Agreementmentioning

confidence: 99%

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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Acute kidney injury (AKI) is a syndrome that has progressed a great deal over the last 20 years. The decrease in urine output and the increase in classical renal biomarkers, such as blood urea nitrogen and serum creatinine, have largely been used as surrogate markers for decreased glomerular filtration rate (GFR), which defines AKI. However, using such markers of GFR as criteria for diagnosing AKI has several limits including the difficult diagnosis of non-organic AKI, also called "functional renal insufficiency" or "pre-renal insufficiency". This situation is characterized by an oliguria and an increase in creatininemia as a consequence of a reduction in renal blood flow related to systemic haemodynamic abnormalities. In this situation, "renal insufficiency" seems rather inappropriate as kidney function is not impaired. On the contrary, the kidney delivers an appropriate response aiming to recover optimal systemic physiological haemodynamic conditions. Considering the kidney as insufficient is erroneous because this suggests that it does not work correctly, whereas the opposite is occurring, because the kidney is healthy even in a threatening situation. With current definitions of AKI, normalization of volaemia is needed before defining AKI in order to avoid this pitfall.

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Section: (Grade 2+) Strong Agreementmentioning

confidence: 99%

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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“…Norepinephrine is the endogenous mediator of the sympathetic system having a strongadrenergic activity with less -adrenergic effects.It increases MAP by vasoconstriction, with small (10-15%) increase in cardiac output and stroke volume [53][54][55][56][57][58] .Filling pressure is either unchanged [59] or modestly increased (1-3 mm Hg) [54][55][56][57]. In open labels trials, norepinephrine at doses ranges 0.01 to 3.3µg/kg/min has demonstrated to increase MAP in patients who remained hypotensive after fluid resuscitation and dopamine [54-56 , 58, 60, 64-65].…”

Section: Norepinephrinementioning

confidence: 99%

Update in the Treatment of Severe Sepsis and Septic Shock

Boodoosingh¹,

Cruz²,

Egozcue³

et al. 2012

Severe Sepsis and Septic Shock - Understanding a Serious Killer

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“…49,55,57 Other vasopressors, such as epinephrine and vasopressin, may also be used in septic patients, although current practice in Canadian EDs is limited. Vasopressin is a potent vasoconstrictor that acts as an agonist at the V1 receptor to constrict vascular smooth muscle.…”

Section: 45mentioning

confidence: 99%

Canadian Association of Emergency Physicians Sepsis Guidelines: the optimal management of severe sepsis in Canadian emergency departments

Green

Djogovic

Gray

et al. 2008

CJEM

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Introduction:Optimal management of severe sepsis in the ED has evolved rapidly. The purpose of these guidelines is to review key management principles for Canadian emergency physicians, utilizing an evidence-based grading system. Methods: Key areas in the management of septic patents were determined by members of the CAEP Critical Care Interest Group (C4). Members of C4 were assigned a question to be answered after literature review, based on the Oxford grading system. After completion, each section underwent a secondary review by another member of C4. A tertiary review was conducted by additional external experts, and modifications were determined by consensus. Grading was based on peer-reviewed publications only, and where evidence was insufficient to address an important topic, a "practice point" was provided based on group opinion. Results: The project was initiated in 2005 and completed in December 2007. Key areas which were reviewed include the definition of sepsis, the use of invasive procedures, fluid resuscitation, vasopressor/inotrope use, the importance of culture acquisition in the ED, antimicrobial therapy and source control. Other areas reviewed included the use of corticosteroids, activated protein C, transfusions and mechanical ventilation. Conclusion: Early sepsis management in the ED is paramount for optimal patient outcomes. The CAEP Critical Care Interest Group Sepsis Position Statement provides a framework to improve the ED care of this patient population. CAEP UPDATE • MISE À JOUR DE L'ACMU

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Norepinephrine therapy has no deleterious renal effects in human septic shock

Cited by 185 publications

References 0 publications

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Update in the Treatment of Severe Sepsis and Septic Shock

Canadian Association of Emergency Physicians Sepsis Guidelines: the optimal management of severe sepsis in Canadian emergency departments

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