| Full text | |
| Author(s): |
Correa, Thiago D.
[1, 2]
;
Jeger, Victor
[3, 1, 2]
;
Pereira, Adriano Jose
[1, 2]
;
Takala, Jukka
[1, 2]
;
Djafarzadeh, Siamak
[1, 2]
;
Jakob, Stephan M.
[1, 2]
Total Authors: 6
|
| Affiliation: | [1] Univ Bern, Bern - Switzerland
[2] Univ Hosp Bern, Inselspital, Dept Intens Care Med, CH-3010 Bern - Switzerland
[3] Univ Bern, Grad Sch Cellular & Biomed Sci, Bern - Switzerland
Total Affiliations: 3
|
| Document type: | Journal article |
| Source: | Critical Care Medicine; v. 42, n. 8, p. E550-E559, AUG 2014. |
| Web of Science Citations: | 23 |
| Abstract | |
Objectives: To compare effects of norepinephrine and angiotensin II in experimental sepsis on hemodynamics, organ function, and mitochondrial respiration. Design: Randomized, controlled, study. Setting: University experimental laboratory. Subjects: Twenty-eight anesthetized, mechanically ventilated pigs. Interventions: Sixteen pigs were randomized to receive after 12 hours of fecal peritonitis fluid resuscitation and either norepineph-rine (group NE; n = 8) or angiotensin II (group AT-II; n = 8) for 48 hours. A separate group (n = 8), treated with enalapril for 1 week before peritonitis and until study end, received fluids and norepinephrine (group E). The blood pressure dose-response to angiotensin II was evaluated in additional four nonseptic pigs. Measurements and Main Results: Blood pressure -target (75-85 mm Hg) was reached in both NE and AT-II, and cardiac output increased similarly (NE: from 64 mL/kg/min {[}60-79 mL/kg/min] to 139 mL/kg/min {[}126-157 mL/kg/min]; AT-II from 79 mL/kg/min {[}65-86 mL/kg/min] to 145 mL/kg/min {[}126-147 mL/kg/min]; median, interquartile range). Renal plasma flow, prevalence of acute kidney injury, inflammation and coagulation patterns, and mitochondrial respiration did not differ between NE and AT-II. In group E, blood pressure targets were not achieved (mean arterial pressure at study end: NE: 81 mm Hg {[}76-85 mm Hg]; AT-II: 80 mm Hg {[}77-84 mm Hg]; E: 53 mm Hg {[}49-66 mm Hg], p = 0.002, compared to NE), whereas skeletal muscle adenosine triphosphate concentrations were increased. During resuscitation one animal died in groups AT-II and E. Conclusions: Angiotensin II reversed sepsis-induced hypotension with systemic and regional hemodynamic effects similar to those of norepinephrine. Inhibition of angiotensin-converting enzyme before sepsis worsened the hypotension but enhanced skeletal muscle adenosine triphosphate. Modifying the renin-angiotensin system in sepsis should be further evaluated. (AU) | |
| FAPESP's process: | 11/22188-6 - Effects of angiotensin and angiotensin-converting enzyme inhibition on hepatic, and renal perfusion, organ function, and on the hepatic arterial buffer response in septic and healthy animals |
| Grantee: | Adriano José Pereira |
| Support Opportunities: | Scholarships abroad - Research |