This article is part of the supplement: 27th International Symposium on Intensive Care and Emergency Medicine
Glibenclamide dose response in patients with septic shock
1 University of Rome 'La Sapienza', Rome, Italy
2 University Hospital of Muenster, Germany
Critical Care 2007, 11(Suppl 2):P7 doi:10.1186/cc5167
The electronic version of this article is the complete one and can be found online at:
| Published: | 22 March 2007 |
© 2007 BioMed Central Ltd.
Introduction
(K+ATP) channels are implicated in the pathophysiology of catecholamine tachyphylaxis in septic shock. This prospective, randomized, double-blinded, clinical study was designed to determine whether different doses of glibenclamide have any effects on norepinephrine requirements and cardiopulmonary hemodynamics in patients with septic shock.
Methods
We enrolled 30 patients with septic shock requiring invasive hemodynamic monitoring and norepinephrine infusion ≥ 0.5 μg/kg/min to maintain MAP between 65 and 75 mmHg. Patients were randomized to receive either 10, 20, or 30 mg enteral glibenclamide. Systemic hemodynamics, global oxygen transport, arterial lactate concentrations, gas exchange, and plasma glucose concentrations were determined at baseline, and following 3, 6 and 12 hours after administration of the study drug.
Results
Glibenclamide decreased plasma glucose concentrations in a dose-dependent manner, but failed to reduce norepinephrine requirements. None of the doses had any effects on cardiopulmonary hemodynamics. See Table 1.
Table 1. Plasma glucose concentration (mg/dl)
Conclusion
Oral glibenclamide is an ineffective adjunct in the treatment of catecholamine-dependent human septic shock.