Impaired β-adrenergic receptor stimulation of cyclic adenosine monophosphate in human septic shock

Q: What does this research mean for the field?

In patients with septic shock, impaired beta-adrenergic receptor stimulation of cyclic adenosine monophosphate is associated with myocardial hyporesponsiveness to catecholamines, contributing to reduced myocardial performance. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Henry Silverman; RUBEN PENARANDA; Jonathan B. Orens; Norman H. Lee

doi:10.1097/00003246-199301000-00010

January 1, 1993Critical Care Medicine

Impaired β-adrenergic receptor stimulation of cyclic adenosine monophosphate in human septic shock

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Why the study?

Is myocardial hyporesponsiveness to catecholamines in human sepsis associated with impaired beta-adrenergic receptor stimulation of cyclic adenosine monophosphate?

Key Points

This study aims to investigate if impaired beta-adrenergic receptor stimulation affects heart function in septic shock patients.
Conducted in a medical ICU at a university hospital with normal volunteers and patients with sepsis and septic shock.
Measured hemodynamic data and cyclic adenosine monophosphate levels after catecholamine administration.
Compared hemodynamic values between septic shock and non-shock patients.
Septic shock patients had significantly lower hemodynamic values compared to non-shock patients (p < .01 to p < .001).
Cyclic adenosine monophosphate accumulations were significantly reduced in septic shock patients (p < .01 and p < .001).
The heart rate response to dobutamine in septic shock patients was significantly lower (p < .01) than in septic patients.

Structured PICO

Is myocardial hyporesponsiveness to catecholamines in human sepsis associated with impaired beta-adrenergic receptor stimulation of cyclic adenosine monophosphate?

P

Population

49 subjects including normal human volunteers (n=7), critically ill non-septic patients (n=9), septic patients not in shock (n=16), and septic patients in shock (n=17) in a medical ICU.

I

Intervention

Sequential infusions of dobutamine (5 and 10 micrograms/kg/min) and measurement of isoproterenol and sodium fluoride-stimulated cyclic adenosine monophosphate accumulations in circulating lymphocytes.

C

Comparator

Comparisons across groups: normal volunteers, critically ill non-septic, septic non-shock, and septic shock patients.

O

Outcome

Hemodynamic response to dobutamine and cyclic adenosine monophosphate accumulations.surrogate

Septic shock is associated with impaired beta-adrenergic receptor stimulation of cAMP, which may contribute to myocardial hyporesponsiveness to catecholamines.

Implication

Impaired beta-adrenergic cAMP response may underlie hyporesponsiveness in septic shock; extends mechanistic observations but leaves open therapeutic implications.

Abstract

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Discussion

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Cite This Study

Silverman et al. (1993) studied this question.

synapsesocial.com/papers/6a1b81f36a7f159d19e8d3e8 https://doi.org/10.1097/00003246-199301000-00010

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Impaired β-adrenergic receptor stimulation of cyclic adenosine monophosphate in human septic shock

Key Points

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Impaired β-adrenergic receptor stimulation of cyclic adenosine monophosphate in human septic shock

Key Points

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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