The Impact of Norepinephrine on Myocardial Perfusion in Critical Illness

      Recent data suggest targeting higher mean arterial pressure (MAP) using norepinephrine reduces myocardial injury in cardiogenic shock.
      • Ameloot K.
      • Jakkula P.
      • Hästbacka J.
      • Reinikainen M.
      • Pettilä V.
      • Loisa P.
      • et al.
      Optimum blood pressure in patients with shock after acute myocardial infarction and cardiac arrest.
      Despite being recommended in international guidelines, the impact of norepinephrine on coronary perfusion in critical illness has not been widely studied. Myocardial contrast echocardiography (MCE) is a well-validated method of qualitative and quantitative assessment of myocardial perfusion in the noncritically ill.
      • Wei K.
      • Jayaweera A.R.
      • Firoozan S.
      • Linka A.
      • Skyba D.M.
      • Kaul S.
      Quantification of myocardial blood flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion.
      We therefore examined coronary perfusion along with its clinical determinants in an unselected critical care cohort. Our aim was to investigate whether MCE can be used to assess norepinephrine-related perfusion abnormalities that could be responsible for reduced left ventricular function.

      Keywords

      Abbreviations:

      MAP (Mean arterial pressure), MBF (Myocardial blood flow), MCE (Myocardial contrast echocardiography)
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        Optimum blood pressure in patients with shock after acute myocardial infarction and cardiac arrest.
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        Quantification of myocardial blood flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion.
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