Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Minerva Anestesiologica 2007 June;73(6) > Minerva Anestesiologica 2007 June;73(6):367-70

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Estratti
Permessi

 

CASE REPORTS   Freefree

Minerva Anestesiologica 2007 June;73(6):367-70

Copyright © 2007 EDIZIONI MINERVA MEDICA

lingua: Inglese

A normal response to Synachten test does not rule out corticosteroid effectiveness in weaning from catecholamine after septic shock

Cavaliere F., Craba A., Caputo C., Gaspari R., Conti G., Proietti R.

Institute of Anaesthesia and Critical Care, Catholic University of the Sacred Heart, Rome, Italy


PDF


Corticosteroids may improve haemodynamics and facilitate weaning from catecholamines in septic shock. According to some authors, such effects are only accomplished in the presence of absolute or relative adrenal insufficiency. Consequently, corticosteroids are usually given only to patients that present low blood cortisol values or show an inadequate response to cosyntropin (Synachten test). We report the case of a woman affected by septic shock secondary to pneumonia and dependent on norepinephrine infusion for 26 days, who was weaned from catecholamines with hydrocortisone, 100 mg/day i.v. She exhibited a normal response to Synachten, but corticosteroid therapy was continued because haemodynamics improved promptly. A pharmacological effect was hypothesized; the contemporary increase of platelet, decrease of white blood cells, and decrease of plasma fibrinogen supported this hypothesis.

inizio pagina