Experience with phenylephrine as a component of the pharmacologie support of septic shock

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Abstract
Objective To evaluate the use of the selective α1-adrenergic receptor agonist phenylephrine in the hemodynamic support of patients with septic shock. Design Retrospective analysis of clinical use of phenylephrine. Setting Surgical ICU in a university hospital. Patients Thirteen patients with septic shock (diagnosed by defined criteria) requiring pharmacologie support for the treatment of hypotension. Interventions and Main Results All patients underwent invasive hemodynamic monitoring followed by volume resuscitation and inotropic support to reverse flow-dependent oxygen consumption and lactic acidosis. Patients with persistent hypotension (mean arterial pressure [MAP] 2). Cardiac index was unchanged initially but increased at the time of highest o2 (p < .05). Pulmonary artery occlusion pressure and heart rate were unchanged. Average baseline o2 increased from 145 to 200 mL/min·m2 and oxygen delivery (Ḋo2) increased from 447 to 597 mL/min-m2 during phenylephrine treatment (p < .05). Blood lactate concentrations decreased and urine output increased significantly (p < .05), while serum creatinine concentrations remained unchanged during phenylephrine therapy. Conclusions Treatment with phenylephrine was associated with beneficial hemodynamic effects when used to maintain perfusion, while increasing Ḋo2 and o2 in patients with septic shock.

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