Dopexamine attenuates flow motion in ileal mucosal arterioles in normotensive sepsis.

OBJECTIVES: Injury to the small intestine is thought to play a crucial role in the development and propagation of sepsis. Cellular hypoxia, caused by hypoperfusion, may result in increased mucosal permeability, thus allowing the translocation of bacteria and endotoxin to the circulation. The purpose of this study was to assess the effect of the synthetic catecholamine, dopexamine, on the mucosal microcirculation of the septic rat ileum.
DESIGN: Randomized, crossover study.
SETTING: Teaching hospital animal laboratory.
SUBJECTS: Sprague-Dawley male rats.
INTERVENTIONS: Sepsis was induced by cecal ligation and perforation in 11 male Sprague-Dawley rats. Six sham animals were also studied. At 24 hrs, rats were anaesthetized, intubated, ventilated, and prepared for intravital microscopy of the mucosal surface of the ileum. Dopexamine (8 microg/kg/min) and saline were infused intravenously into each rat using a randomized crossover design.
MEASUREMENTS AND MAIN RESULTS: Observations were videotaped for later analysis of arteriolar flow patterns, red cell velocity, arteriolar diameter, and intercapillary area. All values are expressed as mean +/- SEM. The main effect of dopexamine infusion in the sepsis group was the attenuation of the rhythmic blood flow patterns (flow motion) observed during saline infusion. In each subject, dopexamine decreased the absolute number of arterioles exhibiting flow motion by 35.93+/-6.81% (p<.001, paired t-test). Dopexamine decreased the amount of time red cell flow was stopped in marginal and central arterioles by 11.83+/-2.49% (p<.001, paired t-test). Dopexamine did not alter significantly the diameter of the marginal arterioles, the intercapillary area, or the red cell velocity compared with saline in the sepsis group. The sham group displayed marked microvascular differences compared with the sepsis group with respect to arteriolar diameter (13.32+/-0.05 vs. 9.46+/-0.24 mm, p<.001), intercapillary area (975.93+/-60.60 vs. 1256.03+/-43.88 mm2, p<.05 ), red cell velocity (611.40+/-38.77 vs. 289.15+/-36.45, p<.001), and blood flow patterns (% displaying flow motion, 15.89+/-6.09 vs. 58.22+/-9.63, p<.01; % time stopped flow, 1.96+/-0.89 vs. 20.21+/-3.92, p<.005).
CONCLUSIONS: These results indicate that dopexamine increased overall blood flow and possibly oxygen delivery to the mucosa by altering patterns of blood flow within the villi. The observation that the diameter of the marginal arterioles is not affected by dopexamine indicates that dopexamine influences the mucosal microcirculation at the level of higher order arterioles. We conclude that sepsis results in abnormal microvascular villus blood flow and that dopexamine can partially restore these changes towards normal.