ArticleCritical care (London, England)2009
Pharmacokinetics of epinephrine in patients with septic shock: modelization and interaction with endogenous neurohormonal status.
Article in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 46 citations in OpenAlex.
- Vasopressor Strategy in Pediatric Sepsis: A Clinical Pharmacology Perspective.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026Article
- Engineering Human 3D Cardiac Tissues for Predictive Functional Drug Screening.Pharmaceutics · 2025Article
- Epinephrine-induced lactic acidosis during the management of anaphylactic shock: a case report.Clinical and experimental emergency medicine · 2025Article
- Catecholamine concentration as a predictor of mortality in emergency surgical patients.International journal of emergency medicine · 2024Article
- Implementation and Evaluation of Weight-Based Vasopressors in Intensive Care Units.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2024Article
- Evaluation of Dose Requirements Using Weight-Based versus Non-Weight-Based Dosing of Norepinephrine to Achieve a Goal Mean Arterial Pressure in Patients with Septic Shock.Journal of clinical medicine · 2023Article
- Apelin-13 in septic shock: effective in supporting hemodynamics in sheep but compromised by enzymatic breakdown in patients.Scientific reports · 2021Article
- Solid-Contact Ion-Selective Electrodes for Histamine Determination.Sensors (Basel, Switzerland) · 2021Article
- A serotonin voltammetric biosensor composed of carbon nanocomposites and DNA aptamer.Mikrochimica acta · 2021Article
- Drug dosing in the critically ill obese patient: a focus on medications for hemodynamic support and prophylaxis.Critical care (London, England) · 2021Review
- Epinephrine Dose Has a Preventive Effect on the Occurrence of Stress Ulcer-Induced Gastrointestinal Bleeding in Critically Ill Patients.Digestive diseases and sciences · 2018Observational
- Outcome of patients with septic shock and high-dose vasopressor therapy.Annals of intensive care · 2017Article
- A Clinical Trial Simulation Evaluating Epinephrine Pharmacokinetics at various Dosing Frequencies during Cardiopulmonary Resuscitation.MEDtube science · 2016Article
- Population pharmacokinetics and haemodynamic effects of norepinephrine in hypotensive critically ill children.British journal of clinical pharmacology · 2014Article
- Pharmacokinetics, hemodynamic and metabolic effects of epinephrine to prevent post-operative low cardiac output syndrome in children.Critical care (London, England) · 2014Article
- Catecholamine dosing and survival in adult intensive care unit patients.World journal of surgery · 2013Article
- Improvement of left ventricular relaxation as assessed by tissue Doppler imaging in fluid-responsive critically ill septic patients.Intensive care medicine · 2012Article
- Epinephrine kinetics in septic shock--a means to understand variable catecholamine efficiency?Critical care (London, England) · 2009Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn septic patients, an unpredictable response to epinephrine may be due to pharmacodynamic factors or to non-linear pharmacokinetics. The purpose of this study was to investigate the pharmacokinetics of epinephrine and its determinants in patients with septic shock.
methodsThirty-eight consecutive adult patients with septic shock were prospectively recruited immediately before epinephrine infusion. A baseline blood sample (C0) was taken to assess endogenous epinephrine, norepinephrine, renin, aldosterone, and plasma cortisol levels before epinephrine infusion. At a fixed cumulative epinephrine dose adjusted to body weight and under steady-state infusion, a second blood sample (C1) was taken to assess epinephrine and norepinephrine concentrations. Data were analyzed using the nonlinear mixed effect modeling software program NONMEM.
resultsPlasma epinephrine concentrations ranged from 4.4 to 540 nmol/L at steady-state infusion (range 0.1 to 7 mg/hr; 0.026 to 1.67 microg/kg/min). A one-compartment model adequately described the data. Only body weight (BW) and New Simplified Acute Physiologic Score (SAPSII) at intensive care unit admission significantly influenced epinephrine clearance: CL (L/hr) = 127 x (BW/70)0.60 x (SAPS II/50)-0.67. The corresponding half-life was 3.5 minutes. Endogenous norepinephrine plasma concentration significantly decreased during epinephrine infusion (median (range) 8.8 (1 - 56.7) at C0 vs. 4.5 (0.3 - 38.9) nmol/L at C1, P < 0.001).
conclusionsEpinephrine pharmacokinetics is linear in septic shock patients, without any saturation at high doses. Basal neurohormonal status does not influence epinephrine pharmacokinetics. Exogenous epinephrine may alter the endogenous norepinephrine metabolism in septic patients.
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