from The American Heritage® Dictionary of the English Language, 5th Edition.
- adjective Characterized by great or heightened activity or change.
- adjective Exhibiting an abnormally large amount of power or force, as of muscular contraction.
from The Century Dictionary.
- In pathology, characterized by excessive violence or excitement, as the vital powers in some kinds or states of disease.
from Wiktionary, Creative Commons Attribution/Share-Alike License.
- adjective physiology Describing an increase in both
blood pressureand pulse pressure
from Wiktionary, Creative Commons Attribution/Share-Alike License
In a dose-response study, phenylephrine was administered to hyperdynamic septic patients who were normotensive at the time of drug therapy. 124 In incremental doses of 0.5 to 8 µg / kg / min, phenylephrine increased MAP, systemic vascular resistance, and stroke index, while no change was seen in cardiac index.
Differential impairment of vascular reactivity of small pulmonary and systemic arteries in hyperdynamic sepsis.
Inotropic Therapy When adequately fluid resuscitated, most septic patients are hyperdynamic, but myocardial contractility, as assessed by ejection fraction, is impaired. 4 Some patients, especially those with preexisting cardiac dysfunction, may have decreased cardiac output and may require inotropic agents such as dobutamine, dopamine, and epinephrine.
Unfortunately, there are only a few studies evaluating the clinical use of phenylephrine in hyperdynamic sepsis.
Martin et al. 97 prospectively randomized 32 volume-resuscitated patients with hyperdynamic sepsis syndrome to receive either dopamine or norepinephrine to achieve and maintain normal hemodynamic and oxygen transport parameters for at least 6 hrs.
Inotropic Therapy in Sepsis Overview Sepsis is characterized by a hyperdynamic state, with normal-to-low blood pressure, normal-to-high cardiac index, and a low systemic vascular resistance. 1,43 Although cardiac output is usually maintained in the volume-resuscitated septic patient, a number of investigations4,125,126 have demonstrated that cardiac function is impaired.
The contrasting effects of dopamine and norepinephrine on systemic and splanchnic oxygen utilization in hyperdynamic sepsis.
But in the current hyperdynamic situation, I believe we need to focus on dancing with the new, not fighting with it.
Generation of the hyperdynamic state is dependent on fluid repletion.
It may be used as an alternative agent in patients with hyperdynamic septic shock who require a vasopressor agent but would not benefit from a further increase in cardiac inotropic function.