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Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity?

Catecholamines have been suggested to modulate innate immune responses in experimental settings. The significance hereof in the treatment of human septic shock is unknown. We therefore sought if and how vasopressor/inotropic doses relate to pro-inflammatory mediators during treatment of septic shock...

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Autores principales: Hartemink, Koen J., Groeneveld, A. B. Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282003/
https://www.ncbi.nlm.nih.gov/pubmed/21347606
http://dx.doi.org/10.1007/s10753-011-9306-8
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author Hartemink, Koen J.
Groeneveld, A. B. Johan
author_facet Hartemink, Koen J.
Groeneveld, A. B. Johan
author_sort Hartemink, Koen J.
collection PubMed
description Catecholamines have been suggested to modulate innate immune responses in experimental settings. The significance hereof in the treatment of human septic shock is unknown. We therefore sought if and how vasopressor/inotropic doses relate to pro-inflammatory mediators during treatment of septic shock. We prospectively studied 20 consecutive septic shock patients. For 3 days after admission, hemodynamic variables, lactate and plasma levels of interleukins (IL)-6 and 8, tumor necrosis factor (TNF)-α, and elastase-α(1)-antitrypsin were measured six hourly. Doses of vasoactive drugs were recorded. Of the 20 patients, nine died in the intensive care unit. Dobutamine doses were positively associated and related to TNF-α plasma levels, independently of disease severity, hemodynamics, and outcome, in multivariable models. Dopamine doses were positively associated with IL-6, and norepinephrine was inversely associated with IL-8 and TNF-α levels. Our observations suggest that catecholamines used in the treatment of human septic shock differ in their potential modulation of the innate immune response to sepsis in vivo. Dobutamine treatment may contribute to circulating TNF-α and dopamine to IL-6, independently of activated neutrophils. Conversely, norepinephrine may lack pro-inflammatory actions.
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spelling pubmed-32820032012-03-01 Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity? Hartemink, Koen J. Groeneveld, A. B. Johan Inflammation Article Catecholamines have been suggested to modulate innate immune responses in experimental settings. The significance hereof in the treatment of human septic shock is unknown. We therefore sought if and how vasopressor/inotropic doses relate to pro-inflammatory mediators during treatment of septic shock. We prospectively studied 20 consecutive septic shock patients. For 3 days after admission, hemodynamic variables, lactate and plasma levels of interleukins (IL)-6 and 8, tumor necrosis factor (TNF)-α, and elastase-α(1)-antitrypsin were measured six hourly. Doses of vasoactive drugs were recorded. Of the 20 patients, nine died in the intensive care unit. Dobutamine doses were positively associated and related to TNF-α plasma levels, independently of disease severity, hemodynamics, and outcome, in multivariable models. Dopamine doses were positively associated with IL-6, and norepinephrine was inversely associated with IL-8 and TNF-α levels. Our observations suggest that catecholamines used in the treatment of human septic shock differ in their potential modulation of the innate immune response to sepsis in vivo. Dobutamine treatment may contribute to circulating TNF-α and dopamine to IL-6, independently of activated neutrophils. Conversely, norepinephrine may lack pro-inflammatory actions. Springer US 2011-02-24 2012 /pmc/articles/PMC3282003/ /pubmed/21347606 http://dx.doi.org/10.1007/s10753-011-9306-8 Text en © The Author(s) 2011 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Article
Hartemink, Koen J.
Groeneveld, A. B. Johan
Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity?
title Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity?
title_full Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity?
title_fullStr Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity?
title_full_unstemmed Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity?
title_short Vasopressors and Inotropes in the Treatment of Human Septic Shock: Effect on Innate Immunity?
title_sort vasopressors and inotropes in the treatment of human septic shock: effect on innate immunity?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282003/
https://www.ncbi.nlm.nih.gov/pubmed/21347606
http://dx.doi.org/10.1007/s10753-011-9306-8
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