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Misdirected Sympathy: The Role of Sympatholysis in Sepsis and Septic Shock.
J Intensive Care Med
February 2018
2 Department of Pharmacy Services, University of Kentucky Healthcare, Lexington, KY, USA.
The spectrum of sepsis and septic shock remains a highly prevalent disease state, carrying a high risk of morbidity and mortality. The sympathetic nervous system (SNS) plays an important role in this initial cascade, enabling the host to respond to invading pathogens; however, prolonged activation can become pathological. The potential for unregulated sympathetic tone to become of detriment in patients with sepsis has fueled interest in the role and impact of sympatholysis, the selective inhibition of sympathetic tone.
View Article and Find Full Text PDFFactors affecting fetal bradycardia following combined spinal epidural for labor analgesia: a matched case-control study.
J Anesth
April 2013
Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore.
Purpose: The combined spinal epidural (CSE) technique for labor analgesia has become increasingly popular owing to its rapid onset of analgesia. However, incidences of fetal bradycardia following CSE have been reported. This study aimed to identify predictors of fetal bradycardia post CSE, such as a decrease in pain scores, the block height, Prostin (dinoprostone; Pfizer) use, and dosage of oxytocin.
View Article and Find Full Text PDFFunctional sympatholysis during exercise in patients with type 2 diabetes with intact response to acetylcholine.
Diabetes Care
May 2011
The Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen, Denmark.
Objective: Sympathetic vasoconstriction is blunted in contracting human skeletal muscles (functional sympatholysis). In young subjects, infusion of adenosine and ATP increases blood flow, and the latter compound also attenuates α-adrenergic vasoconstriction. In patients with type 2 diabetes and age-matched healthy subjects, we tested 1) the sympatholytic capacity during one-legged exercise, 2) the vasodilatory capacity of adenosine and ATP, and 3) the ability to blunt α-adrenergic vasoconstriction during ATP infusion.
View Article and Find Full Text PDFChemical sympatholysis: indications, technique and complications.
Br J Hosp Med (Lond)
November 2008
Department of Surgery, Queen Mary's Hospital, Sidcup, Kent DA14 6LT.
Chemical sympatholysis is commonly performed for palmar or plantar hyperhidrosis, Buerger's disease, critical lower limb ischaemia where there is no revascularization option available and palliation of pain. The outcome varies from symptomatic improvement to failure, which may result in limb loss in the case of ischaemic limbs.
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