Vasopressin vs. norepinephrine in endotoxic shock: systemic, renal, and splanchnic hemodynamic and oxygen transport effects
Vasopressin vs. norepinephrine in endotoxic shock: systemic, renal, and splanchnic hemodynamic and oxygen transport effects
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DOI：
10.1152/japplphysiol.00017.2003
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发表时间：
2003-08-01
影响因子：
3.3
通讯作者：
Kruse, JA
中科院分区：
文献类型：
--
作者：
Guzman, JA;Rosado, AE;Kruse, JA
在基础条件下和内毒素休克期间，研究了静脉输注去甲肾上腺素（NE，第1组）和加压素（AVP，第2组）对麻醉犬体循环、内脏循环和肾循环的影响。在基础条件下，AVP输注导致左心室每搏功下降12 +/- 7%，门静脉血流量下降45 +/- 5%，肠粘膜血流量下降31 +/- 13%（P < 0.05）。AVP还减少内脏氧输送（DO 2）和增加内脏和肾脏氧提取显着在基础条件。除了第2组动物中更明显的心动过缓外，内毒素休克期间研究组之间的全身和内脏变化相当。与NE复苏的动物相比，AVP输注恢复了内毒素休克中的肾血流量和DO 2，NE复苏的动物具有持续低的肾血流量和DO 2。我们的数据表明，与NE相反，AVP的管理有效地恢复肾血流量和DO 2具有可比的全身和内脏血液动力学和代谢作用内毒素诱导的循环休克。
The effects of intravenous norepinephrine (NE, group 1) and vasopressin (AVP, group 2) infusions on systemic, splanchnic, and renal circulations were studied in anesthetized dogs under basal conditions and during endotoxic shock. Under basal conditions, AVP infusion induced a 12 +/- 7% drop in left ventricular stroke work, a 45 +/- 5% fall in portal venous blood flow, and a 31 +/- 13% decrease in intestinal mucosal blood flow ( P < 0.05). AVP also decreased splanchnic oxygen delivery (DO2) and increased splanchnic and renal oxygen extraction significantly during basal conditions. Except for more pronounced bradycardia among animals in group 2, the systemic and splanchnic changes were comparable between study groups during endotoxic shock. AVP infusion restored renal blood flow and DO2 in endotoxic shock compared with animals resuscitated with NE, which had persistently low renal blood flow and DO2. Our data demonstrate that, in contrast to NE, administration of AVP effectively restores renal blood flow and DO2 with comparable systemic and splanchnic hemodynamic and metabolic effects in endotoxin-induced circulatory shock.