Abstrakt

Serotonin and interventions in intensive care.

Pavel Kohout*, Marcela Kanova

Serotonin (5-hydroxytryptamine, 5-HT) plays two important roles in humans – one central and the other peripheral – depending on the location of the 5-HT pools of on either side of the blood-brain barrier. In the central nervous system, it acts as a neurotransmitter, controlling such brain functions as autonomic neural activity, stress response, body temperature, sleep, mood, and appetite. This role is very important in intensive care, as critically ill patients are usually under medications like opioids, antiemetics, antidepressants and other serotoninergic agents. High serotonin levels lead to altered mental status, deliria, rigidity, and myoclonus – together recognised as serotonin syndrome. In its role as a peripheral hormone, serotonin is unique in controlling the functions of several organs. It also has fundamental effects on haemostasis, vascular tone, heart rate, respiratory drive, cell growth and immunity. Serotonin regulates almost all immune cells in response to inflammation, following the activation of platelets.