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01-03-2007 | Experimental

Effects of levosimendan and dobutamine in experimental acute endotoxemia: a preliminary controlled study

Authors: Arnaldo Dubin, Gastón Murias, Juan Pablo Sottile, Mario Omar Pozo, Marcelo Barán, Vanina Siham Kanoore Edul, Héctor Saúl Canales, Graciela Etcheverry, Bernardo Maskin, Elisa Estenssoro

Published in: Intensive Care Medicine | Issue 3/2007

Abstract

Objective

To test the hypothesis that levosimendan increases systemic and intestinal oxygen delivery (DO₂) and prevents intramucosal acidosis in septic shock.

Design

Prospective, controlled experimental study.

Setting

University-based research laboratory.

Subjects

Nineteen anesthetized, mechanically ventilated sheep.

Interventions

Endotoxin-treated sheep were randomly assigned to three groups: control (n = 7), dobutamine (10 μg/kg/min, n = 6) and levosimendan (100 μg/kg over 10 min followed by 100 μg/kg/h, n = 6) and treated for 120 min.

Measurements and main results

After endotoxin administration, systemic and intestinal DO₂ decreased (24.6 ± 5.2 vs 15.3 ± 3.4 ml/kg/min and 105.0 ± 28.1 vs 55.8 ± 25.9 ml/kg/min, respectively; p < 0.05 for both). Arterial lactate and the intramucosal–arterial PCO₂ difference (ΔPCO₂) increased (1.4 ± 0.3 vs 3.1 ± 1.5 mmHg and 9 ± 6 vs 23 ± 6 mmHg mmol/l, respectively; p < 0.05). Systemic DO₂ was preserved in the dobutamine-treated group (22.3 ± 4.7 vs 26.8 ± 7.0 ml/min/kg, p = NS) but intestinal DO₂ decreased (98.9 ± 0.2 vs 68.0 ± 22.9 ml/min/kg, p < 0.05) and ΔPCO₂ increased (12 ± 5 vs 25 ± 11 mmHg, p < 0.05). The administration of levosimendan prevented declines in systemic and intestinal DO₂ (25.1 ± 3.0 vs 24.0 ± 6.3 ml/min/kg and 111.1 ± 18.0 vs 98.2 ± 23.1 ml/min/kg, p = NS for both) or increases in ΔPCO₂ (7 ± 7 vs 10 ± 8, p = NS). Arterial lactate increased in both the dobutamine and levosimendan groups (1.6 ± 0.3 vs 2.5 ± 0.7 and 1.4 ± 0.4 vs. 2.9 ± 1.1 mmol/l, p = NS between groups).

Conclusions

Compared with dobutamine, levosimendan increased intestinal blood flow and diminished intramucosal acidosis in this experimental model of sepsis.

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Title: Effects of levosimendan and dobutamine in experimental acute endotoxemia: a preliminary controlled study
Authors: Arnaldo Dubin
Gastón Murias
Juan Pablo Sottile
Mario Omar Pozo
Marcelo Barán
Vanina Siham Kanoore Edul
Héctor Saúl Canales
Graciela Etcheverry
Bernardo Maskin
Elisa Estenssoro
Publication date: 01-03-2007
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-006-0519-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of levosimendan and dobutamine in experimental acute endotoxemia: a preliminary controlled study

Abstract

Objective

Design

Setting

Subjects

Interventions

Measurements and main results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Subjects

Interventions

Measurements and main results

Conclusions

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