ZHANG Hui, GUO Yan. Effect of norepinephrine combined with esmolol on myocardial function and lactate clearance rate in patients with septic shock[J]. Journal of Clinical Medicine in Practice, 2019, 23(17): 10-13, 16. DOI: 10.7619/jcmp.201917003
Citation: ZHANG Hui, GUO Yan. Effect of norepinephrine combined with esmolol on myocardial function and lactate clearance rate in patients with septic shock[J]. Journal of Clinical Medicine in Practice, 2019, 23(17): 10-13, 16. DOI: 10.7619/jcmp.201917003

Effect of norepinephrine combined with esmolol on myocardial function and lactate clearance rate in patients with septic shock

More Information
  • Received Date: July 05, 2019
  • Accepted Date: August 21, 2019
  • Available Online: February 28, 2021
  • Published Date: September 14, 2019
  •   Objective  To investigate the effect of norepinephrine combined with esmolol on myocardial function and lactate clearance rate in patients with septic shock.
      Methods  Totally 100 septic shock patients were divided into control group (n=48) and observation group (n=52) according to the order of hospital admission. All the patients were treated with standard anti-infection and fluid resuscitation. The control group was treated with norepinephrine on this basis, while the observation group was treated with esmolol on the basis of the control group. The mechanical ventilation time, hospital stay in intensive care unit (ICU), recovery success rate within 6 hours, myocardial function, blood lactate concentration and lactate clearance rate, tissue perfusion, sequential organ failure estimation (SOFA) score, acute physiology and chronic health (APACHE Ⅱ) score were compared between the two groups.
      Results  The duration of mechanical ventilation and hospital stay in ICU in the observation group were significantly shorter than those in the control group, while the success rate of resuscitation within 6 hours and lactate clearance rate after 7 days of treatment were significantly higher than those in the control group (P < 0.05). Before treatment, there were no significant differences in B-type natriuretic peptide (BNP), troponin T (cTnT), creatine phosphate isoenzyme (CK-MB), urine volume, central venous oxygen saturation (ScvO2), SOFA score and APACHE Ⅱ score between the two groups (P>0.05). After treatment, BNP, cTnT and CK-MB, SOFA score and APACHE II score in both groups decreased significantly (P < 0.05), and the above indexes in the observation group were significantly lower than those in the control group (P < 0.05), while urine volume and ScvO2 were significantly higher than those before treatment (P < 0.05), and urine volume and ScvO2 in the observation group were significantly higher than those in the control group (P < 0.05).
      Conclusion  Norepinephrine combined with esmolol can improve the curative effect of patients with septic shock, protect myocardial function, improve lactate clearance rate and reduce the degree of hypoxia in patients′ tissues.
  • [1]
    Genga K R, Shimada T, Boyd J H, et al. The Understanding and Management of Organism Toxicity in Septic Shock[J]. J Innate Immun, 2018, 10(5/6): 502-514. http://europepmc.org/abstract/MED/29763894
    [2]
    江乐, 应利君, 吕铁. 乳酸清除率对感染性创面导致脓毒性休克患者疗效与生存状况的评估价值[J]. 中华医院感染学杂志, 2017, 27(9): 1959-1962. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY201709011.htm
    [3]
    耿丽娟, 李素玮, 张永利, 等. 脓毒症心肌损伤发病机制的研究进展[J]. 中华内科杂志, 2015, 54(1): 77-80. doi: 10.3760/cma.j.issn.0578-1426.2015.01.023
    [4]
    胡才宝, 严静. 感染性休克血管活性药物选择策略[J]. 中国实用内科杂志, 2015, 35(11): 900-903. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201511005.htm
    [5]
    杨建坤, 赵丽. 血管活性药物治疗脓毒症休克的研究进展[J]. 实用医学杂志, 2018, 34(11): 1808-1811. doi: 10.3969/j.issn.1006-5725.2018.11.014
    [6]
    高戈, 冯喆, 常志刚, 等. 2012国际严重脓毒症及脓毒性休克诊疗指南[J]. 中华危重病急救医学, 2013, 25(8): 501-505. doi: 10.3760/cma.j.issn.2095-4352.2013.08.016
    [7]
    林丽丽, 陈锡明. 序贯器官衰竭评估[J]. 青岛医药卫生, 2006, 38(1): 63-65. doi: 10.3969/j.issn.1006-5571.2006.01.046
    [8]
    谢铎文, 潘景业. 急性生理学与慢性健康状况评分系统: 1978-2010[J]. 中国中西医结合急救杂志, 2010, 17(6): 378-381. https://www.cnki.com.cn/Article/CJFDTOTAL-SHXJ201605007.htm
    [9]
    Jouffroy R, Saade A, Muret A, et al. Fluid resuscitation in pre-hospital patients with septic shock: one size does not fit all[J]. Am J Emerg Med, 2019, 37(1): 169-171. doi: 10.1016/j.ajem.2018.05.057
    [10]
    Lundberg O H, Bergenzaun L, Rydén J, et al. Adrenomedullin and endothelin-1 are associated with myocardial injury and death in septic shock patients[J]. Crit Care, 2016, 20(1): 178-185. doi: 10.1186/s13054-016-1361-y
    [11]
    胡才宝, 严静. 感染性休克血管活性药物选择策略[J]. 中国实用内科杂志, 2015, 35(11): 900-903. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201511005.htm
    [12]
    邢适颖, 董平栓, 李志娟, 等. 去甲肾上腺素对感染性休克患者血流动力学与肾灌注的影响[J]. 中华医院感染学杂志, 2018, 28(19): 33-37. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY201819007.htm
    [13]
    刘健, 张勤. 脓毒症休克患者停用血管升压素后血流动力学不稳定[J]. 中华烧伤杂志, 2018, 34(4): 196-196.
    [14]
    高雪花, 曹雯, 关银, 等. 艾司洛尔对脓毒症患者心肌损伤的保护作用[J]. 中国急救医学, 2015, 35(8): 678-682. doi: 10.3969/j.issn.1002-1949.2015.08.002
    [15]
    周仪华, 苑会晶, 袁影, 等. 艾司洛尔对脓毒症休克患者左室功能及预后的影响[J]. 中华急诊医学杂志, 2019, 28(1): 100-103. doi: 10.3760/cma.j.issn.1671-0282.2019.01.019
    [16]
    唐翔诩. 阻断β1肾上腺素受体可提高实验性脓毒性休克大鼠的心脏和血管功能[J]. 中国病理生理杂志, 2016, 32(1): 82-84. https://www.cnki.com.cn/Article/CJFDTOTAL-ZBLS201601016.htm
    [17]
    余言午, 孙同文, 万有栋, 等. β受体阻滞剂对脓毒性休克患者疗效的荟萃分析[J]. 中华医学杂志, 2016, 96(7): 570-574. doi: 10.3760/cma.j.issn.0376-2491.2016.07.017
    [18]
    韩斌, 郑文香, 曹新河, 等. 脓毒血症时心肌损伤分子细胞层发病机制及生物标志物研究进展[J]. 河北医药, 2017, 39(19): 3011-3015. doi: 10.3969/j.issn.1002-7386.2017.19.038
    [19]
    闫丽梅. 脓毒症休克患者心肌损伤程度及预后判断的研究[J]. 中国医师进修杂志, 2014, 37(10): 36-39. doi: 10.3760/cma.j.issn.1673-4904.2014.10.012
    [20]
    罗运山, 刘易林, 李莉. 血乳酸动态检测及APACHEⅡ评分对脓毒症预后的评估价值[J]. 重庆医学, 2017, 46(24): 3351-3353. doi: 10.3969/j.issn.1671-8348.2017.24.012
    [21]
    洪欢, 彭松, 张琳. 早期乳酸清除率对脓毒症患者预后的评估[J]. 临床急诊杂志, 2016, 17(12): 930-931, 934. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZLC201612010.htm
  • Related Articles

    [1]ZHANG Si, LI Hui. Monocentric analysis of risk factors for pulmonary tuberculosis co-infected with pulmonary aspergillosis[J]. Journal of Clinical Medicine in Practice, 2025, 29(6): 45-50. DOI: 10.7619/jcmp.20244101
    [2]JU Jiyin. Analysis of risk factors of postoperative pulmonary infection in patients with esophageal cancer and its intensive nursing[J]. Journal of Clinical Medicine in Practice, 2018, (6): 60-63. DOI: 10.7619/jcmp.201806018
    [3]WANG Ling, LI Jingjiang, ZHOU Yu. Effect of nursing intervention in prevention of pulmonary infection in emergency intensive care unit[J]. Journal of Clinical Medicine in Practice, 2018, (2): 32-34. DOI: 10.7619/jcmp.201802010
    [4]ZHANG Yue, YU Xiaojiang. Effect of comfort care on improving pulmonary infection of chronic obstructive pulmonary disease patients combined with pulmonary heart disease in ICU[J]. Journal of Clinical Medicine in Practice, 2017, (8): 30-33,38. DOI: 10.7619/jcmp.201708010
    [5]WANG Xuena. Clinical nursing of patients with bronchial obstruction caused by Y stent implantation[J]. Journal of Clinical Medicine in Practice, 2017, (6): 104-106. DOI: 10.7619/jcmp.201706032
    [6]CHEN Lu, MENG Yanni, HUANG Jianbao, CHEN Yanping. Application of fiber bronchoscope in diagnosis and treatment of children mycoplasma pneumoniae pneumonia complicated with pulmonary atelectasis[J]. Journal of Clinical Medicine in Practice, 2015, (23): 78-81. DOI: 10.7619/jcmp.201523024
    [7]ZHANG Xiayi, WANG Huize. Effects of nursing care intervention in operating room on preventing postoperative pulmonary infection[J]. Journal of Clinical Medicine in Practice, 2014, (20): 94-95,101. DOI: 10.7619/jcmp.201420029
    [8]LI Ying. Comprehensive nursing intervention of lung infection in patients with severe craniocerebral injury combined with pulmonary contusion[J]. Journal of Clinical Medicine in Practice, 2014, (6): 35-38. DOI: 10.7619/jcmp.201406012
    [9]ZHAO Zhihong, QIU Hao. Related factors of postoperative pulmonary complications in elderly patients with esophageal cancer[J]. Journal of Clinical Medicine in Practice, 2013, (16): 101-103. DOI: 10.7619/jcmp.201316039
    [10]WANG Bei-hong, WANG Zhen-kai, CHENG Bao-jing, WAN Yu, ZHANG Ke. The application of bronchoscopy in the treatment of postoperative atelectasis in children with thoracic surgery[J]. Journal of Clinical Medicine in Practice, 2011, (17): 92-93. DOI: 10.3969/j.issn.1672-2353.2011.17.032
  • Cited by

    Periodical cited type(8)

    1. 田美莉. 氨甲环酸联合葡萄糖酸钙治疗产后出血的临床效果. 妇儿健康导刊. 2024(04): 90-92 .
    2. 李相茹. 氨甲环酸联合麦角新碱预防剖宫产产后出血的效果. 中国民康医学. 2024(07): 71-74 .
    3. 郭丽平,陈秋连,陈琳. 氨甲环酸联合缩宫素预防瘢痕子宫再次分娩后恶露不尽的效果及对凝血功能的影响. 中国医学创新. 2024(17): 145-148 .
    4. 刘伟,曹玉枝,田润芝,曹晨,李桂青. 悬浮红细胞与新鲜冰冻血浆不同比例输注联合氨甲环酸治疗产后出血的效果对比. 中国妇幼保健. 2024(16): 3034-3037 .
    5. 王晨. 氨甲环酸联合麦角新碱对产后出血产妇的治疗效果. 实用中西医结合临床. 2024(12): 35-37+128 .
    6. 张美琳,于楠楠. 麦角新碱联合氨甲环酸治疗产后宫缩乏力性出血的临床效果以及对子宫复旧、凝血功能的影响. 中国当代医药. 2024(33): 88-91 .
    7. 符海萍. 氨甲环酸联合缩宫素对预防剖宫产产后出血的效果及改善凝血功能的临床研究. 现代医学与健康研究电子杂志. 2023(17): 56-58 .
    8. 彭玲玲,郝然,吴俞萱,李娟,谌艳. 局部应用氨甲环酸联合磺胺嘧啶银脂质水胶敷料对骨科大手术后切口渗血的影响. 中国当代医药. 2023(36): 46-50 .

    Other cited types(1)

Catalog

    Article views (371) PDF downloads (5) Cited by(9)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return