Revista médica de Chile
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Revista médica de Chile · Jun 1999
Randomized Controlled Trial Clinical Trial[Acute effect of dobutamine and amrinone on hemodynamics and splanchnic perfusion in septic shock patients].
Vasoactive drugs used in the reanimation of septic patients, can modify splanchnic perfusion. ⋯ An improvement in gastric pHi associated with an increase in oxygen delivery, was observed with dobutamine. Amrinone showed no effect at the fixed, low dose used in the study.
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This was a lecture given by Monsignor Piñera, Honorary Member of the Chilean Academy of Medicine who is a Bishop of the Catholic Church and also an MD. The author addresses the problem of the dying patient in the different positions held by a churchman and by the physician. ⋯ But in both positions, hope must be sustained to the very end and due respect to the patient's will as a human being has to be maintained, helping him her to die with dignity and the best comfort available. Unnecessary or unjustified measures to resuscitate or to prolong life are criticised.
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Revista médica de Chile · Jun 1999
Review[Effect of catecholamines on splanchnic perfusion in sepsis].
Splanchnic ischemia is frequent in sepsis and septic shock and is related to impairment in intestinal permeability, derangement in mucosal barrier functions and translocation of proinflammatory mediators. These changes can contribute to the pathogenesis of multiple organ failure. ⋯ On the other hand, epinephrine further impairs splanchnic perfusion. In view of the contradictory effects of different vasoactive drugs, gastric tonometry must be measured during their use, to find the optimal drug combination that optimizes splanchnic blood flow.