Sepsis and acute respiratory distress syndrome

Prostaglandins and TXA2 have been demonstrated to be part of the complex network of mediators determining the pathophysiology of sepsis and acute respiratory distress syndrome.

TXA2 is a major mediator of ischemia and shock, whereas epoprostenol and the PGEs exert potentially beneficial effects. In general, infusing epoprostenol and PGE 1 into patients with sepsis and/or acute respiratory distress syndrome improves cardiac output, right ventricular function, systemic oxygen delivery, and/or consumption, and decreases both mean arterial and pulmonary artery pressure, without affecting overall survival in multicenter trials. Moreover, recent studies show improved glucose metabolism and splanchnic oxygenation with epoprostenol infusion in patients with sepsis and septic shock ( Sche.e.r§Q,.§Qd,

The intravenous application of epoprostenol and PGE 1 is limited by potential adverse effects such as hypotension and hypoxemia caused by increased pulmonary shunt (Schee.^eQ,aQd.,Raderm.§.9h.e^,1.997.).

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