Efficacy of selective mineralocorticoid and glucocorticoid agonists in canine septic shock
Efficacy of selective mineralocorticoid and glucocorticoid agonists in canine septic shock
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DOI：
10.1097/ccm.0b013e31822efa14
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发表时间：
2012-01-01
影响因子：
8.8
通讯作者：
Natanson, Charles
中科院分区：
文献类型：
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作者：
Hicks, Caitlin W.;Sweeney, Daniel A.;Natanson, Charles
目的：同时刺激矿皮质激素和糖皮质激素通路的皮质类固醇治疗方案可持续逆转感染性休克中血管加压剂依赖性低血压，但对生存的影响不同。本研究的目的是确定外源性矿皮质激素和糖皮质激素治疗是否有不同的效果，以及给药时间是否会改变它们对感染性休克的影响。设计、环境、受试者和干预措施：去氧皮质酮，一种选择性矿物皮质激素激动剂；地塞米松，一种选择性糖皮质激素激动剂；在74只患有葡萄球菌肺炎的犬中，安慰剂在感染前几天（预防性）或感染后立即（治疗性）给予，并持续96 HRS。测量结果和主要结果：去氧皮质酮和地塞米松对生存的影响随给药时间不同而不同或相反（p = 0.05）；液体需要量（p = 0.05）；中心静脉压(p
Objective: Corticosteroid regimens that stimulate both mineralocorticoid and glucocorticoid pathways consistently reverse vasopressor-dependent hypotension in septic shock but have variable effects on survival. The objective of this study was to determine whether exogenous mineralocorticoid and glucocorticoid treatments have distinct effects and whether the timing of administration alters their effects in septic shock.Design, Setting, Subjects, and Interventions: Desoxycorticosterone, a selective mineralocorticoid agonist; dexamethasone, a selective glucocorticoid agonist; and placebo were administered either several days before (prophylactic) or immediately after (therapeutic) infectious challenge and continued for 96 hrs in 74 canines with staphylococcal pneumonia.Measurements and Main Results: Effects of desoxycorticosterone and dexamethasone were different and opposite depending on timing of administration for survival (p = .05); fluid requirements (p = .05); central venous pressures (p