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Critical Care
Published in: Critical Care 3/2003

01-06-2003 | Review

Clinical review: Influence of vasoactive and other therapies on intestinal and hepatic circulations in patients with septic shock

Authors: Pierre Asfar, Daniel De Backer, Andreas Meier-Hellmann, Peter Radermacher, Samir G Sakka

Published in: Critical Care | Issue 3/2003

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Abstract

The organs of the hepatosplanchnic system are considered to play a key role in the development of multiorgan failure during septic shock. Impaired oxygenation of the intestinal mucosa can lead to disruption of the intestinal barrier, which may promote a vicious cycle of inflammatory response, increased oxygen demand and inadequate oxygen supply. Standard septic shock therapy includes supportive treatment such as fluid resuscitation, administration of vasopressors (adrenergic and nonadrenergic drugs), and respiratory and renal support. These therapies may have beneficial or detrimental effects not only on systemic haemodynamics but also on splanchnic haemodynamics, at both the macrocirculatory and microcirculatory levels. This clinical review focuses on the splanchnic haemodynamic and metabolic effects of standard therapies used in patients with septic shock, as well as on the recently described nonconventional therapies such as vasopressin, prostacyclin and N-acetyl cysteine.
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Metadata
Title
Clinical review: Influence of vasoactive and other therapies on intestinal and hepatic circulations in patients with septic shock
Authors
Pierre Asfar
Daniel De Backer
Andreas Meier-Hellmann
Peter Radermacher
Samir G Sakka
Publication date
01-06-2003
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2003
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc2418

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