Critical Care

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Commentary

Epinephrine kinetics in septic shock – a means to understand variable catecholamine efficiency?

Enrico Calzia1, Michael Georgieff1, Markus Huber-Lang2 and Peter Radermacher1*

Author Affiliations

1 Sektion Anästhesiologische Pathopyhsiologie und Verfahrensentwicklung, Klinik für Anästhesiologie, Parkstrasse 11, 89073 Ulm, Germany

2 Klinik für Unfall-, Hand-, Plastische- und Wiederherstellungschirurgie, Universitätsklinikum, Steinhövelstrasse 9, 89075 Ulm, Germany

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Critical Care 2009, 13:177 doi:10.1186/cc7987

Published: 13 August 2009

Abstract

It is well-established that the hemodynamic response to infusing catecholamines, the most frequently applied drugs for circulatory support during shock states, may vary markedly within and between individuals. In this context it is striking that only scarce data are available on the pharmacokinetics of catecholamines in critically ill patients. Furthermore, the existing literature comprises fairly equivocal observations. Abboud and colleagues now report that, in patients with septic shock, epinephrine kinetics are linear and its clearance directly depends on body weight and is inversely related to the severity of the disease. The authors conclude that the endogenous adrenal axis hormones do not assume any additional importance.