Estatísticas

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    "titulo" => "Efeitos hemodinâmicos e metabólicos da infusão de vasopressina em crianças com choque"
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          <html><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vasopressin is a neuropeptide hormone which has been used clinically for more than 50 years and plays a major role in circulatory homeostasis and in the regulation of serum osmolality. Recent work has emphasized its role in the treatment of septic shock. This paper reviews the physiology of this neurohormone and the available evidence in favor of its use as a vasodilator for children in shock.</p>\n
          \t\t\t\t\t\t   </span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Sources</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">MEDLINE, using the terms vasopressin, vasodilation, shock and septic shock, plus synonyms and related terms. Classic publications on the topic were also reviewed and selected depending on their relevance to the study objectives.</p>\n
          \t\t\t\t\t\t   </span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Summary of the findings</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vasopressin is synthesized in the neurohypophysis and released in response to a decrease in plasma volume or an increase in serum osmolality. The action of vasopressin is mediated by the activation of oxytocin receptors and of several G protein-coupled receptors, which are classified according to their location and intracellular transmission routes as V1 receptors (or V1b), V2 and V3 receptors (or V1b). The main role of vasopressin is to induce vasoconstriction. However, in certain organs, it can also induce selective vasodilation. Several clinical studies in adults and children have reported that the effects of vasopressin for the treatment of vasodilatory septic shock, due to a variety of causes, are both beneficial and safe.</p>\n
          \t\t\t\t\t\t   </span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conclusions</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The evidence is restricted. Most studies are retrospective and include a small number of patients. Nevertheless, there is significant experience concerning the use of vasopressin in Pediatrics. Vasopressin has a beneficial clinical effect in children and can be indicated in the treatment of refractory vasodilatory shock, after adequate volume resuscitation and when high doses of other vasopressors are not effective.</p>\n
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        "resumen" => "<html><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A vasopressina &eacute; um horm&ocirc;nio neuropept&iacute;dico utilizado clinicamente h&aacute; mais de 50 anos, com papel importante na homeostase circulat&oacute;ria e na regula&ccedil;&atilde;o da osmolalidade s&eacute;rica. Seu papel no tratamento do choque vem recebendo &ecirc;nfase recentemente. Foram revisadas a fisiologia deste neuro-horm&ocirc;nio e as evid&ecirc;ncias dispon&iacute;veis para sua utiliza&ccedil;&atilde;o no contexto de choque com vasodilata&ccedil;&atilde;o na crian&ccedil;a.</p></span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fontes dos dados</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">MEDLINE, usando os termos vasopressin, vasodilation, shock, septic shock, e sin&ocirc;nimos e termos relacionados, al&eacute;m de publica&ccedil;&otilde;es cl&aacute;ssicas referentes ao tema, sendo escolhidas as mais representativas.</p></span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">S&iacute;ntese dos dados</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A vasopressina &eacute; sintetizada na neuro-hip&oacute;fise e liberada em resposta &agrave; diminui&ccedil;&atilde;o da volemia ou ao aumento da osmolalidade plasm&aacute;tica. A a&ccedil;&atilde;o da vasopressina d&aacute;-se pela ativa&ccedil;&atilde;o de v&aacute;rios receptores acoplados &agrave; prote&iacute;na G, os quais s&atilde;o classificados, de acordo com sua localiza&ccedil;&atilde;o e rotas de transmiss&atilde;o intracelular, em receptores V1 (ou V1b), V2 e V3 (ou V1b) e por receptores de ocitocina. A fun&ccedil;&atilde;o central da vasopressina &eacute; causar vasoconstri&ccedil;&atilde;o, embora, em determinados &oacute;rg&atilde;os, possa promover vasodilata&ccedil;&atilde;o seletiva. Diversos estudos cl&iacute;nicos em adultos e crian&ccedil;as apontam efeitos ben&eacute;ficos e seguros da vasopressina no tratamento do choque com vasodilata&ccedil;&atilde;o por diversas causas.</p></span><span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conclus&atilde;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">As evid&ecirc;ncias s&atilde;o restritas, os estudos na maioria s&atilde;o retrospectivos e com n&uacute;mero reduzido de pacientes, mas j&aacute; h&aacute; uma experi&ecirc;ncia bastante significativa no que diz respeito a seu uso em pediatria. A vasopressina possui um efeito clinico ben&eacute;fico na crian&ccedil;a e pode ser indicada no tratamento do choque refrat&aacute;rio com vasodilata&ccedil;&atilde;o, depois de adequada reposi&ccedil;&atilde;o vol&ecirc;mica e quando altas doses de outros vasopressores n&atilde;o foram eficazes.</p></span></html>"
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