Principes du traitement de l'état choc chez le malade bêtabloqué

Betablockers are extensively used but have been recently questioned about their perioperative administration when patients are susceptible to experience unstable haemodynamic condition. Betabloquers impair the efficacy of fluid infusion to treat hypovolemia. Betablockers reverse the effects of epinephrine while the impact on dobutamine effects varies depending on the agent administered. Phenyleprine administration may lead to acute cardiac failure by uncompensated stimulation of alpha1 adrenergic receptors. No significant interaction is documented between betablockers and phosphodiesterase inhibitors and levosimendan. Glucagon may be used in betablocked patients suffering from anaphylactic shock. Betablocker intoxication may be treated by high doses of insulin coupled with potassium and glucose administration.