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Crit Care. 2009;13(6):1001. doi: 10.1186/cc8133. Epub 2009 Nov 6.

Anaesthesia in septic patients: good preparation and making the right choice?

Author information

  • 1Department of Pharmacology, Medical Building, University of Melbourne, Carlton, Victoria 3010, Australia. colin.royse@unimelb.edu.au

Abstract

Septic patients may require anaesthesia for surgery or to facilitate endotracheal intubation for respiratory failure. These patients frequently start with a deranged haemodynamic state, including vasodilation with hypotension, and cardiomyopathy, making induction of anaesthesia a potentially hazardous task. Anaesthetic agents are well known to decrease contractility and to cause vasodilation - in part from direct effect of the drugs, and in part due to the state of anaesthesia, that causes reduced sympathetic tone. Before induction, the physician should understand the haemodynamic state (especially using echocardiography), should restore cardiovascular reserve with inotropes and vasopressors, and should induce anaesthesia with the smallest dose of the safest drug. In the previous issue of Critical Care, Zausig and colleagues show that propofol may not be the safest choice of induction agent in septic patients.

PMID:
19895717
[PubMed - indexed for MEDLINE]
PMCID:
PMC2811922
Free PMC Article
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