Literature DB >> 8565517

Adrenergic vasopressor agents and mechanical ventilation for the treatment of experimental septic shock.

W Tang1, J L Pakula, M H Weil, M Noc, M Fukui, J Bisera.   

Abstract

OBJECTIVE: Vasopressor agents and mechanical ventilation are routine interventions for the treatment of sepsis complicated by hypotension. It was our hypothesis that such treatment singly or in combination increases the duration of survival.
DESIGN: Prospective, randomized, controlled study.
SETTING: University research laboratory.
SUBJECTS: Thirty male Sprague-Dawley rats anesthetized with intraperitoneal injection of pentobarbital.
INTERVENTIONS: Peritonitis was induced by cecal ligation and spillage of cecal contents into the abdominal cavity. The first phase of this study was performed on 15 spontaneously breathing Sprague-Dawley rats that were randomized to three groups of five animals each. One group received treatment with dopamine. The second group received norepinephrine. The third group received only the diluent as a placebo. Concentrations of the vasopressor agents were increased such that mean arterial pressure was maintained at approximately 80% of baseline values; the volumes infused were kept constant. For the second phase of this study, the grouping of animals and the techniques of study were identical, except that rats were mechanically ventilated.
MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure was best maintained with norepinephrine. However, no statistically significant differences in duration of survival, cardiac index, arterial blood lactate concentration, or arterial and venous PCO2 and PO2 values were identified between groups. With mechanical ventilation, survival was prolonged (p < .01). Survival was increased from an average of 291 mins to 342 mins with dopamine, from 257 mins to 352 mins in placebo controls, and from 280 mins to 329 mins with norepinephrine. Again, no significant differences in hemodynamic and blood gas measurements, or in the duration of survival between vasopressor-treated and control animals were documented.
CONCLUSIONS: No benefit or detriment was demonstrated when vasopressor agents were administered to sustain arterial pressure in the course of experimental peritonitis in this murine model of septic shock. This finding contrasted with highly significant prolongation of survival when animals were mechanically ventilated. There was no evidence that routine vasopressor therapy, under these controlled experimental conditions in rats, improved duration of survival.

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Year:  1996        PMID: 8565517     DOI: 10.1097/00003246-199601000-00021

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  6 in total

1.  Part 10: Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.

Authors:  Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman
Journal:  Circulation       Date:  2010-10-19       Impact factor: 29.690

2.  Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations.

Authors:  Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman
Journal:  Pediatrics       Date:  2010-10-18       Impact factor: 7.124

Review 3.  Adjunctive drug treatment in severe hypoxic respiratory failure.

Authors:  S Elsasser; H Schächinger; W Strobel
Journal:  Drugs       Date:  1999-09       Impact factor: 9.546

4.  Early septic shock induces loss of oxidative phosphorylation yield plasticity in liver mitochondria.

Authors:  Pierre Eyenga; Damien Roussel; Jérôme Morel; Benjamin Rey; Caroline Romestaing; Loic Teulier; Shey-Shing Sheu; Joelle Goudable; Claude Négrier; Jean Paul Viale
Journal:  J Physiol Biochem       Date:  2014-02-26       Impact factor: 4.158

5.  Liberal vs. conservative vasopressor use to maintain mean arterial blood pressure during resuscitation of septic shock: an observational study.

Authors:  Sanjay Subramanian; Murat Yilmaz; Ahmer Rehman; Rolf D Hubmayr; Bekele Afessa; Ognjen Gajic
Journal:  Intensive Care Med       Date:  2007-10-09       Impact factor: 17.440

6.  Mechanical ventilation preserves diaphragm mitochondrial function in a rat sepsis model.

Authors:  P Eyenga; D Roussel; B Rey; P Ndille; L Teulier; F Eyenga; C Romestaing; J Morel; V Gueguen-Chaignon; S-S Sheu
Journal:  Intensive Care Med Exp       Date:  2021-04-07
  6 in total

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