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miércoles, 30 de octubre de 2013

Esmolol en shock séptico

PulmCCM Oct 29, 2013
"Do I.V. Beta-Blockers Save Lives in Septic Shock?
Catecholamines can be toxic — just ask anyone experiencing the heartbreak of tako-tsubo syndrome. Blocking the heart-flogging effects of the hormones epinephrine (adrenaline) and norepinephrine have long been known to improve long-term survival in congestive heart failure. People with septic shock might be the last group you’d consider giving beta-blockers, but a pilot study showed oral metoprolol improved cardiac output and markers of perfusion among 40 septic shock patients, without apparent adverse effects. A new phase 2 randomized trial in JAMA takes the concept to the next step, and floats the provocative idea that aggressive catecholamine blockade with esmolol saves lives in people with septic shock."
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