HWN Suggests

Catecholamines helpful or harmful in critical illness?

Despite high catecholamines in sepsis, blood pressure is often low in septic shock. One reason for low blood pressure in sepsis is activation of inducible nitric oxide synthase... along with depressed cardiac contractility... In response to low blood pressure, clinicians attempt to fix the problem by giving catecholamine vasopressors – most often norepinephrine. These come with some unintended consequences, and recent studies suggest that infusing catecholamine vasopressors harms some patients.

Recent studies comparing different blood pressure targets in sepsis have suggested that there is no benefit, and possible harm to higher (e.g. more “normal”) blood pressure in patients with sepsis.

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Articles of Interest

All About Catecholamines in the Stress Response

Catecholamines are an important part of the body's stress response, which can be vital in a fight-or-flight response to a perceived threat. They are produced in the adrenal glands, the brainstem, and the brain. In the brain they act as neurotransmitters. In the blood they circulate and act as hormones and are broken down after just a few minutes. They are then excreted in the urine.

Catecholamines: Direct influence in mood and health

Catechol-awhat? Most have probably only heard the word ‘catecholamines’ in passing or during a brief lesson in science class years ago. While the name sounds confusing, catecholamines are integral to the functioning of the human body. These hormones and neurotransmitters influence stress responses, mood, and general health.

Catecholamines—Crafty Weapons in the Inflammatory Arsenal of Immune/Inflammatory Cells or Opening Pandora’s Box?

It is well established that catecholamines (CAs), which regulate immune and inflammatory responses, derive from the adrenal medulla and from presynaptic neurons. Recent studies reveal that T cells also can synthesize and release catecholamines which then can regulate T cell function

Circulating Catecholamines

Circulating catecholamines, epinephrine and norepinephrine, originate from two sources. Epinephrine is released by the adrenal medulla upon activation of preganglionic sympathetic nerves innervating this tissue. This activation occurs during times of stress (e.g., exercise, heart failure, hemorrhage, emotional stress or excitement, pain). Norepinephrine is also released by the adrenal medulla (approximately 20% of its total catecholamine release is norepinephrine); however, the primary source of circulating norepinephrine is spillover from sympathetic nerves innervating blood vessels.

Introduction to Catecholamines

So, I think of a catecholamine as the entire cat from head to tail in its litter box – that is a catecholamine. And here is how a catecholamine synthesis happens. There are only three catecholamines in the body: dopamine, which is an important chemical messenger in the brain, norepinephrine, and adrenaline or epinephrine.

The Catecholamines and Your Ability to Pay Attention

Are you having difficulty concentrating? If you can maintain focus until the end of this blog post, you may learn how your catecholamines are involved in concentration—or lack thereof.

Resources

StatPearls

Catecholamines act both as neurotransmitters and hormones vital to the maintenance of homeostasis through the autonomic nervous system. Physiologic principles of catecholamines have numerous applications within pharmacology.