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Although we found that vasopressin infusion was associ-ated with impaired gastric mucosal perfusion, the possibleeffect of these alterations on outcome is yet to be determined.Indeed, a large multicenter randomized controlled study re-ported that low-dose vasopressin was not associated withreduced mortality rates compared with norepinephrineamong patients with septic shock.33The authors demon-strated a potential benefit of vasopressin in patients with lowto moderate norepinephrine dosage.33A subsequent sub-group analysis showed improved outcome in septic patientswho were treated with a combination of vasopressin andcorticosteroids.34However, in this study,33vasopressin wasadministered at a lower dose than that used in our study.
虽然我们发现垂体后叶素的注射与胃粘膜灌注的损伤有关,但是这些改变对预后的可能影响并没有确定。实际上,一个大样本多中心的随机控制研究再次表明对于感染性休克的病人低剂量的垂体后叶素相对于去甲肾上腺素并没有降低死亡率。作者证实了低到中等剂量的垂体后叶素对于病人潜在的好处。随后的小组分析表明在感染的病人中联合使用垂体后叶素及糖皮质激素对于病人的预后是有利的。但是在哪项研究中,垂体后叶素的剂量比我们此次研究的剂量要低。 |
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