Shock evidence-based treatment

An important overall approach for treatment of sepsis is goal-directed therapy. Mortality can be reduced by early placement and use of a central venous catheter, increased fluid volume administration, dobutamine therapy if needed, and red blood cell transfusion, to achieve specific physiologic goals in the first 6 hours. Evidence-based treatment recommendations for sepsis and septic shock from the Surviving Sepsis campaign are presented in Table 45-3. 

Evidence-Based Treatment Recommendations for Sepsis and Septic Shock... 

Electroconvulsive therapy has been used as antidepressive, mood-stabilizing and antipsychotic treatments (Eitan and Lerer 2006 Shapira et al., 1991). It is reported that electroconvulsive shocks (ECS), an animal model for the ECT, affect the NE system. Thus, both acute and chronic ECS increase cortical and hippocampal NE release. Chronic ECS also desensitize a2-adrenergic autoreceptors in the PFC (Thomas et al., 1992). Paradoxically, electrophysiological studies report that chronic ECS suppress the firing activity of NE neurons in the ECS (Grant and Weiss 2001). Based on the evidences of ECS-induced increase in brain NE levels, it can be concluded that the benefitial effect of the ECT is mediated, at least in part, via NE system. 

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