Effects of vasopressin on microcirculatory blood flow in the gastrointestinal tract in anesthetized pigs in septic shock

2.50
Hdl Handle:
http://hdl.handle.net/2336/12502
Title:
Effects of vasopressin on microcirculatory blood flow in the gastrointestinal tract in anesthetized pigs in septic shock
Authors:
Hiltebrand, Luzius B; Krejci, Vladimir; Jakob, Stephan M; Takala, Jukka; Sigurdsson, Gisli H
Citation:
Anesthesiology 2007, 106(6):1156-67
Issue Date:
1-Jun-2007
Abstract:
BACKGROUND: Vasopressin increases arterial pressure in septic shock even when alpha-adrenergic agonists fail. The authors studied the effects of vasopressin on microcirculatory blood flow in the entire gastrointestinal tract in anesthetized pigs during early septic shock. METHODS: Thirty-two pigs were intravenously anesthetized, mechanically ventilated, and randomly assigned to one of four groups (n=8 in each; full factorial design). Group S (sepsis) and group SV (sepsis-vasopressin) were made septic by fecal peritonitis. Group C and group V were nonseptic control groups. After 300 min, group V and group SV received intravenous infusion of 0.06 U.kg.h vasopressin. In all groups, cardiac index and superior mesenteric artery flow were measured. Microcirculatory blood flow was recorded with laser Doppler flowmetry in both mucosa and muscularis of the stomach, jejunum, and colon. RESULTS: While vasopressin significantly increased arterial pressure in group SV (P<0.05), superior mesenteric artery flow decreased by 51+/-16% (P<0.05). Systemic and mesenteric oxygen delivery and consumption decreased and oxygen extraction increased in the SV group. Effects on the microcirculation were very heterogeneous; flow decreased in the stomach mucosa (by 23+/-10%; P<0.05), in the stomach muscularis (by 48+/-16%; P<0.05), and in the jejunal mucosa (by 27+/-9%; P<0.05), whereas no significant changes were seen in the colon. CONCLUSION: Vasopressin decreased regional flow in the superior mesenteric artery and microcirculatory blood flow in the upper gastrointestinal tract. This reduction in flow and a concomitant increase in the jejunal mucosa-to-arterial carbon dioxide gap suggest compromised mucosal blood flow in the upper gastrointestinal tract in septic pigs receiving low-dose vasopressin.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00000542-200706000-00016&LSLINK=80&D=ovft

Full metadata record

DC FieldValue Language
dc.contributor.authorHiltebrand, Luzius B-
dc.contributor.authorKrejci, Vladimir-
dc.contributor.authorJakob, Stephan M-
dc.contributor.authorTakala, Jukka-
dc.contributor.authorSigurdsson, Gisli H-
dc.date.accessioned2007-07-02T11:47:47Z-
dc.date.available2007-07-02T11:47:47Z-
dc.date.issued2007-06-01-
dc.date.submitted2007-07-02-
dc.identifier.citationAnesthesiology 2007, 106(6):1156-67en
dc.identifier.issn0003-3022-
dc.identifier.pmid17525591-
dc.identifier.doi10.1097/01.anes.0000267599.02140.86-
dc.identifier.urihttp://hdl.handle.net/2336/12502-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Vasopressin increases arterial pressure in septic shock even when alpha-adrenergic agonists fail. The authors studied the effects of vasopressin on microcirculatory blood flow in the entire gastrointestinal tract in anesthetized pigs during early septic shock. METHODS: Thirty-two pigs were intravenously anesthetized, mechanically ventilated, and randomly assigned to one of four groups (n=8 in each; full factorial design). Group S (sepsis) and group SV (sepsis-vasopressin) were made septic by fecal peritonitis. Group C and group V were nonseptic control groups. After 300 min, group V and group SV received intravenous infusion of 0.06 U.kg.h vasopressin. In all groups, cardiac index and superior mesenteric artery flow were measured. Microcirculatory blood flow was recorded with laser Doppler flowmetry in both mucosa and muscularis of the stomach, jejunum, and colon. RESULTS: While vasopressin significantly increased arterial pressure in group SV (P<0.05), superior mesenteric artery flow decreased by 51+/-16% (P<0.05). Systemic and mesenteric oxygen delivery and consumption decreased and oxygen extraction increased in the SV group. Effects on the microcirculation were very heterogeneous; flow decreased in the stomach mucosa (by 23+/-10%; P<0.05), in the stomach muscularis (by 48+/-16%; P<0.05), and in the jejunal mucosa (by 27+/-9%; P<0.05), whereas no significant changes were seen in the colon. CONCLUSION: Vasopressin decreased regional flow in the superior mesenteric artery and microcirculatory blood flow in the upper gastrointestinal tract. This reduction in flow and a concomitant increase in the jejunal mucosa-to-arterial carbon dioxide gap suggest compromised mucosal blood flow in the upper gastrointestinal tract in septic pigs receiving low-dose vasopressin.en
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00000542-200706000-00016&LSLINK=80&D=ovften
dc.subject.meshAnimalsen
dc.subject.meshBlood Pressureen
dc.subject.meshGastrointestinal Tracten
dc.subject.meshHeart Rateen
dc.subject.meshMicrocirculationen
dc.subject.meshShock, Septicen
dc.subject.meshSplanchnic Circulationen
dc.subject.meshSwineen
dc.subject.meshVasoconstrictor Agentsen
dc.subject.meshVasopressinsen
dc.titleEffects of vasopressin on microcirculatory blood flow in the gastrointestinal tract in anesthetized pigs in septic shocken
dc.typeArticleen
dc.identifier.journalAnesthesiologyen
dc.format.digYES-

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