Monday December 19, 2005
Renal Dose Norepinephrine !
This interesting term was coined by Dr. Marik in August 2004 chest journal with final comment: "...In the volume-replete patient, norepinephrine is the vasopressor of choice. Norepinephrine in clinically relevant doses is a friend of the kidney and not a foe" *, while commenting on the study in the same issue from Albanèse and coll. that found that in septic patients norepinephrine infusion reestablished urine flow, with a decrease in serum creatinine levels and an increase in creatinine clearance rate after 24 hours. Although Guidelines published in Critical Care Medicine - November 2004 on "Vasopressor and inotropic support in septic shock: An evidence-based review" still recommends that: "Either norepinephrine or dopamine is the first-choice vasopressor agent to correct hypotension in septic shock." but overall trend is going in favour of norepinephrine.
*From Noradrenaline and the kidney: friends or foes? - Critical Care 2001, 5:294-298
References: Click to get abstract/article
1. Renal Dose Norepinephrine! - Chest. 2004;126:335-337
2. Renal Effects of Norepinephrine in Septic and Nonseptic Patients - Chest. 2004;126:534-539
3. Noradrenaline and the kidney: friends or foes? - Crit Care 2001, 5:294-298
4. Vasopressor and inotropic support in septic shock: An evidence-based review. - Critical Care Medicine. 32(11) Supplement:S455-S465, November 2004