Skip to main content
Top
Published in: Critical Care 4/2006

Open Access 01-08-2006 | Research

Effects of dopexamine on the intestinal microvascular blood flow and leucocyte activation in a sepsis model in rats

Authors: Jürgen Birnbaum, Edda Klotz, Claudia D Spies, Björn Lorenz, Patrick Stuebs, Ortrud Vargas Hein, Matthias Gründling, Dragan Pavlovic, Taras Usichenko, Michael Wendt, Wolfgang J Kox, Christian Lehmann

Published in: Critical Care | Issue 4/2006

Login to get access

Abstract

Introduction

Dopexamine may be a therapeutic option to improve hepatosplanchnic perfusion in sepsis. To investigate this possibility, we administered dopexamine in an experimental sepsis model in rats.

Methods

This prospective, randomized, controlled laboratory study was conducted in 42 Wistar rats. The animals were divided into three groups. Group 1 served as the control group (CON group). The animals in both groups 2 (LPS group) and 3 (DPX group) received an endotoxin (lipopolysaccharide from Escherichia coliLPS) infusion (20 mg/kg for 15 minutes). DPX group additionally received dopexamine (0.5 μg/kg per minute over four hours). One half of the animals in each group underwent studies of intestinal microvascular blood flow (IMBF) using laser Doppler fluxmetry. In the other half an intravital microscopic evaluation of leucocyte-endothelial cell interaction in intestinal microcirculation was conducted. Functional capillary density (FCD) in the intestinal mucosa and in the circular as well as longitudinal muscle layer was estimated.

Results

One hour after endotoxin challenge, IMBF decreased significantly in LPS group to 51% compared with baseline (P < 0.05). In DPX group (endotoxin plus dopexamine) we found IMBF values significantly higher than those in LPS group (approximately at the level of controls). The impaired FCD following endotoxin challenge was improved by dopexamine in the longitudinal muscle layer (+33% in DPX group versus LPS group; P < 0.05) and in the circular muscle layer (+48% in DPX group versus LPS group; P < 0.05). In DPX group, dopexamine administration reduced the number of firmly adherent leucocytes (-31% versus LPS group; P < 0.05). Plasma levels of tumour necrosis factor-α were reduced by dopexamine infusion (LPS group: 3637 ± 553 pg/ml; DPX group: 1933 ± 201 pg/ml) one hour after endotoxin challenge.

Conclusion

Dopexamine administration improved IMBF and FCD (markers of intestinal microcirculation) and reduced leucocyte activation (a marker of inflammation) in experimental sepsis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Carrico CJ, Meakins JL, Marshall JC, Fry D, Maier RV: Multiple-organ-failure syndrome. Arch Surg 1986, 121: 196-208.CrossRefPubMed Carrico CJ, Meakins JL, Marshall JC, Fry D, Maier RV: Multiple-organ-failure syndrome. Arch Surg 1986, 121: 196-208.CrossRefPubMed
2.
3.
go back to reference Russwurm S, Vickers J, Meier-Hellmann A, Spangenberg P, Bredle D, Reinhart K, Losche W: Platelet and leukocyte activation correlate with the severity of septic organ dysfunction. Shock 2002, 17: 263-268. 10.1097/00024382-200204000-00004CrossRefPubMed Russwurm S, Vickers J, Meier-Hellmann A, Spangenberg P, Bredle D, Reinhart K, Losche W: Platelet and leukocyte activation correlate with the severity of septic organ dysfunction. Shock 2002, 17: 263-268. 10.1097/00024382-200204000-00004CrossRefPubMed
4.
go back to reference Tighe D, Moss R, Bennett D: Cell surface adrenergic receptor stimulation modifies the endothelial response to SIRS. Systemic Inflammatory Response Syndrome. New Horiz 1996, 4: 426-442.PubMed Tighe D, Moss R, Bennett D: Cell surface adrenergic receptor stimulation modifies the endothelial response to SIRS. Systemic Inflammatory Response Syndrome. New Horiz 1996, 4: 426-442.PubMed
5.
go back to reference Uusaro A, Ruokonen E, Takala J: Gastric mucosal pH does not reflect changes in splanchnic blood flow after cardiac surgery. Br J Anaesth 1995, 74: 149-154.CrossRefPubMed Uusaro A, Ruokonen E, Takala J: Gastric mucosal pH does not reflect changes in splanchnic blood flow after cardiac surgery. Br J Anaesth 1995, 74: 149-154.CrossRefPubMed
6.
go back to reference Meier Hellmann A, Bredle DL, Specht M, Spies C, Hannemann L, Reinhart K: The effects of low-dose dopamine on splanchnic blood flow and oxygen uptake in patients with septic shock. Intensive Care Med 1997, 23: 31-37. 10.1007/s001340050287CrossRefPubMed Meier Hellmann A, Bredle DL, Specht M, Spies C, Hannemann L, Reinhart K: The effects of low-dose dopamine on splanchnic blood flow and oxygen uptake in patients with septic shock. Intensive Care Med 1997, 23: 31-37. 10.1007/s001340050287CrossRefPubMed
7.
go back to reference Thoren A, Elam M, Ricksten SE: Differential effects of dopamine, dopexamine, and dobutamine on jejunal mucosal perfusion early after cardiac surgery. Crit Care Med 2000, 28: 2338-2343. 10.1097/00003246-200007000-00027CrossRefPubMed Thoren A, Elam M, Ricksten SE: Differential effects of dopamine, dopexamine, and dobutamine on jejunal mucosal perfusion early after cardiac surgery. Crit Care Med 2000, 28: 2338-2343. 10.1097/00003246-200007000-00027CrossRefPubMed
8.
go back to reference Hiltebrand LB, Krejci V, Sigurdsson GH: Effects of dopamine, dobutamine, and dopexamine on microcirculatory blood flow in the gastrointestinal tract during sepsis and anesthesia. Anesthesiology 2004, 100: 1188-1197. 10.1097/00000542-200405000-00022CrossRefPubMed Hiltebrand LB, Krejci V, Sigurdsson GH: Effects of dopamine, dobutamine, and dopexamine on microcirculatory blood flow in the gastrointestinal tract during sepsis and anesthesia. Anesthesiology 2004, 100: 1188-1197. 10.1097/00000542-200405000-00022CrossRefPubMed
9.
go back to reference Sack FU, Reidenbach B, Schledt A, Dollner R, Taylor S, Gebhard MM, Hagl S: Dopexamine attenuates microvascular perfusion injury of the small bowel in pigs induced by extracorporeal circulation. Br J Anaesth 2002, 88: 841-847. 10.1093/bja/88.6.841CrossRefPubMed Sack FU, Reidenbach B, Schledt A, Dollner R, Taylor S, Gebhard MM, Hagl S: Dopexamine attenuates microvascular perfusion injury of the small bowel in pigs induced by extracorporeal circulation. Br J Anaesth 2002, 88: 841-847. 10.1093/bja/88.6.841CrossRefPubMed
10.
go back to reference Lehtipalo S, Biber B, Frojse R, Arnerlov C, Johansson G, Winso O: Does dopexamine influence regional vascular tone and oxygenation during intestinal hypotension? Acta Anaesthesiol Scand 2002, 46: 1217-1226. 10.1034/j.1399-6576.2002.461009.xCrossRefPubMed Lehtipalo S, Biber B, Frojse R, Arnerlov C, Johansson G, Winso O: Does dopexamine influence regional vascular tone and oxygenation during intestinal hypotension? Acta Anaesthesiol Scand 2002, 46: 1217-1226. 10.1034/j.1399-6576.2002.461009.xCrossRefPubMed
11.
go back to reference Bach F, Grundmann U, Bauer M, Buchinger H, Soltesz S, Graeter T, Larsen R, Silomon M: Modulation of the inflammatory response to cardiopulmonary bypass by dopexamine and epidural anesthesia. Acta Anaesthesiol Scand 2002, 46: 1227-1235. 10.1034/j.1399-6576.2002.461010.xCrossRefPubMed Bach F, Grundmann U, Bauer M, Buchinger H, Soltesz S, Graeter T, Larsen R, Silomon M: Modulation of the inflammatory response to cardiopulmonary bypass by dopexamine and epidural anesthesia. Acta Anaesthesiol Scand 2002, 46: 1227-1235. 10.1034/j.1399-6576.2002.461010.xCrossRefPubMed
12.
go back to reference Bohlen HG, Gore RW: Preparation of rat intestinal muscle and mucosa for quantitative microcirculatory studies. Microvasc Res 1976, 11: 103-110. 10.1016/0026-2862(76)90081-9CrossRefPubMed Bohlen HG, Gore RW: Preparation of rat intestinal muscle and mucosa for quantitative microcirculatory studies. Microvasc Res 1976, 11: 103-110. 10.1016/0026-2862(76)90081-9CrossRefPubMed
13.
go back to reference Briers JD: Laser Doppler, speckle and related techniques for blood perfusion mapping and imaging. Physiol Meas 2001, 22: R35-R66. 10.1088/0967-3334/22/4/201CrossRefPubMed Briers JD: Laser Doppler, speckle and related techniques for blood perfusion mapping and imaging. Physiol Meas 2001, 22: R35-R66. 10.1088/0967-3334/22/4/201CrossRefPubMed
14.
go back to reference Gore RW, Bohlen HG: Microvascular pressures in rat intestinal muscle and mucosal villi. Am J Physiol 1977, 233: H685-H693.PubMed Gore RW, Bohlen HG: Microvascular pressures in rat intestinal muscle and mucosal villi. Am J Physiol 1977, 233: H685-H693.PubMed
15.
go back to reference Schmid-Schoenbein GW, Zweifach BW, Kovalcheck S: The application of stereological principles to morphometry of the microcirculation in different tissues. Microvasc Res 1977, 14: 303-317. 10.1016/0026-2862(77)90028-0CrossRefPubMed Schmid-Schoenbein GW, Zweifach BW, Kovalcheck S: The application of stereological principles to morphometry of the microcirculation in different tissues. Microvasc Res 1977, 14: 303-317. 10.1016/0026-2862(77)90028-0CrossRefPubMed
16.
go back to reference Birnbaum J, Lehmann C, Stauss HM, Weber M, Georgiew A, Lorenz B, Pulletz S, Grundling M, Pavlovic D, Wendt M, et al.: Sympathetic modulation of intestinal microvascular blood flow oscillations in experimental endotoxemia. Clin Hemorheol Microcirc 2003, 28: 209-220.PubMed Birnbaum J, Lehmann C, Stauss HM, Weber M, Georgiew A, Lorenz B, Pulletz S, Grundling M, Pavlovic D, Wendt M, et al.: Sympathetic modulation of intestinal microvascular blood flow oscillations in experimental endotoxemia. Clin Hemorheol Microcirc 2003, 28: 209-220.PubMed
17.
go back to reference Bastien O, Piriou V, Aouifi A, Evans R, Lehot JJ: Effects of dopexamine on blood flow in multiple splanchnic sites measured by laser Doppler velocimetry in rabbits undergoing cardiopulmonary bypass. Br J Anaesth 1999, 82: 104-109.CrossRefPubMed Bastien O, Piriou V, Aouifi A, Evans R, Lehot JJ: Effects of dopexamine on blood flow in multiple splanchnic sites measured by laser Doppler velocimetry in rabbits undergoing cardiopulmonary bypass. Br J Anaesth 1999, 82: 104-109.CrossRefPubMed
18.
go back to reference Booker PD, Pozzi M: A placebo-controlled study of the effects of dopexamine on gastric mucosal perfusion in infants undergoing hypothermic cardiopulmonary bypass. Br J Anaesth 2000, 84: 23-27.CrossRefPubMed Booker PD, Pozzi M: A placebo-controlled study of the effects of dopexamine on gastric mucosal perfusion in infants undergoing hypothermic cardiopulmonary bypass. Br J Anaesth 2000, 84: 23-27.CrossRefPubMed
19.
go back to reference Corbett EJ, Barry BN, Pollard SG, Lodge JP, Bellamy MC: Laser Doppler flowmetry is useful in the clinical management of small bowel transplantation. The Liver Transplant Group. Gut 2000, 47: 580-583. 10.1136/gut.47.4.580PubMedCentralCrossRefPubMed Corbett EJ, Barry BN, Pollard SG, Lodge JP, Bellamy MC: Laser Doppler flowmetry is useful in the clinical management of small bowel transplantation. The Liver Transplant Group. Gut 2000, 47: 580-583. 10.1136/gut.47.4.580PubMedCentralCrossRefPubMed
20.
go back to reference Seguin P, Laviolle B, Guinet P, Morel I, Malledant Y, Bellissant E: Dopexamine and norepinephrine versus epinephrine on gastric perfusion in patients with septic shock: a randomized study [NCT00134212]. Crit Care 2006, 10: R32. 10.1186/cc4827PubMedCentralCrossRefPubMed Seguin P, Laviolle B, Guinet P, Morel I, Malledant Y, Bellissant E: Dopexamine and norepinephrine versus epinephrine on gastric perfusion in patients with septic shock: a randomized study [NCT00134212]. Crit Care 2006, 10: R32. 10.1186/cc4827PubMedCentralCrossRefPubMed
21.
go back to reference Muller M, Boldt J, Schindler E, Sticher J, Kelm C, Roth S, Hempelmann G: Effects of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery. Crit Care Med 1999, 27: 2389-2393. 10.1097/00003246-199911000-00011CrossRefPubMed Muller M, Boldt J, Schindler E, Sticher J, Kelm C, Roth S, Hempelmann G: Effects of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery. Crit Care Med 1999, 27: 2389-2393. 10.1097/00003246-199911000-00011CrossRefPubMed
22.
go back to reference McGinley J, Lynch L, Hubbard K, McCoy D, Cunningham AJ: Dopexamine hydrochloride does not modify hemodynamic response or tissue oxygenation or gut permeability during abdominal aortic surgery. Can J Anaesth 2001, 48: 238-244.CrossRefPubMed McGinley J, Lynch L, Hubbard K, McCoy D, Cunningham AJ: Dopexamine hydrochloride does not modify hemodynamic response or tissue oxygenation or gut permeability during abdominal aortic surgery. Can J Anaesth 2001, 48: 238-244.CrossRefPubMed
23.
go back to reference Wayland H: Intravital observatories. Dream or necessity. Int J Microcirc Clin Exp 1990, 9: 1-19.PubMed Wayland H: Intravital observatories. Dream or necessity. Int J Microcirc Clin Exp 1990, 9: 1-19.PubMed
24.
go back to reference Menger MD, Lehr HA: Scope and perspectives of intravital microscopy – bridge over from in vitro to in vivo. Immunol Today 1993, 14: 519-522. 10.1016/0167-5699(93)90179-OCrossRefPubMed Menger MD, Lehr HA: Scope and perspectives of intravital microscopy – bridge over from in vitro to in vivo. Immunol Today 1993, 14: 519-522. 10.1016/0167-5699(93)90179-OCrossRefPubMed
25.
26.
go back to reference Ley K, Tedder TF: Leukocyte interactions with vascular endothelium. New insights into selectin-mediated attachment and rolling. J Immunol 1995, 155: 525-528.PubMed Ley K, Tedder TF: Leukocyte interactions with vascular endothelium. New insights into selectin-mediated attachment and rolling. J Immunol 1995, 155: 525-528.PubMed
27.
go back to reference Granger DN, Kubes P: The microcirculation and inflammation: modulation of leukocyte-endothelial cell adhesion. J Leukoc Biol 1994, 55: 662-675.PubMed Granger DN, Kubes P: The microcirculation and inflammation: modulation of leukocyte-endothelial cell adhesion. J Leukoc Biol 1994, 55: 662-675.PubMed
28.
go back to reference Harlan JM: Leukocyte-endothelial interactions. Blood 1985, 65: 513-525.PubMed Harlan JM: Leukocyte-endothelial interactions. Blood 1985, 65: 513-525.PubMed
29.
go back to reference Volk T, Kox WJ: Endothelium function in sepsis. Inflamm Res 2000, 49: 185-198. 10.1007/s000110050579CrossRefPubMed Volk T, Kox WJ: Endothelium function in sepsis. Inflamm Res 2000, 49: 185-198. 10.1007/s000110050579CrossRefPubMed
30.
go back to reference Pulletz S, Lehmann C, Volk T, Schmutzler M, Ziemer S, Kox WJ, Scherer RU: Influence of heparin and hirudin on endothelial binding of antithrombin in experimental thrombinemia. Crit Care Med 2000, 28: 2881-2886. 10.1097/00003246-200008000-00032CrossRefPubMed Pulletz S, Lehmann C, Volk T, Schmutzler M, Ziemer S, Kox WJ, Scherer RU: Influence of heparin and hirudin on endothelial binding of antithrombin in experimental thrombinemia. Crit Care Med 2000, 28: 2881-2886. 10.1097/00003246-200008000-00032CrossRefPubMed
31.
go back to reference Harlan JM: Neutrophil-mediated vascular injury. Acta Med Scand Suppl 1987, 715: 123-129.PubMed Harlan JM: Neutrophil-mediated vascular injury. Acta Med Scand Suppl 1987, 715: 123-129.PubMed
32.
go back to reference Schmidt W, Hacker A, Gebhard MM, Martin E, Schmidt H: Dopexamine attenuates endotoxin-induced microcirculatory changes in rat mesentery: role of beta2 adrenoceptors. Crit Care Med 1998, 26: 1639-1645. 10.1097/00003246-199810000-00012CrossRefPubMed Schmidt W, Hacker A, Gebhard MM, Martin E, Schmidt H: Dopexamine attenuates endotoxin-induced microcirculatory changes in rat mesentery: role of beta2 adrenoceptors. Crit Care Med 1998, 26: 1639-1645. 10.1097/00003246-199810000-00012CrossRefPubMed
33.
go back to reference Schmidt H: Tierexperimentelle Untersuchungen zur Intestinalen Mikrozirkulation und zum Intestinalen Purinstoffwechsel bei Endotoxinämie. Habilitation: Ruprecht-Karls-Universität Heidelberg; 1997. Schmidt H: Tierexperimentelle Untersuchungen zur Intestinalen Mikrozirkulation und zum Intestinalen Purinstoffwechsel bei Endotoxinämie. Habilitation: Ruprecht-Karls-Universität Heidelberg; 1997.
34.
go back to reference Barroso AJ, Schmid SG, Zweifach BW, Mathison JC: Polymorphonuclear neutrophil contribution to induced tolerance to bacterial lipopolysaccharide. Circ Res 1991, 69: 1196-1206.CrossRef Barroso AJ, Schmid SG, Zweifach BW, Mathison JC: Polymorphonuclear neutrophil contribution to induced tolerance to bacterial lipopolysaccharide. Circ Res 1991, 69: 1196-1206.CrossRef
35.
go back to reference Boillot A, Massol J, Maupoil V, Grelier R, Bernard B, Capellier G, Berthelot A, Barale F: Myocardial and vascular adrenergic alterations in a rat model of endotoxin shock: reversal by an anti-tumor necrosis factor-alpha monoclonal antibody. Crit Care Med 1997, 25: 504-511. 10.1097/00003246-199703000-00021CrossRefPubMed Boillot A, Massol J, Maupoil V, Grelier R, Bernard B, Capellier G, Berthelot A, Barale F: Myocardial and vascular adrenergic alterations in a rat model of endotoxin shock: reversal by an anti-tumor necrosis factor-alpha monoclonal antibody. Crit Care Med 1997, 25: 504-511. 10.1097/00003246-199703000-00021CrossRefPubMed
36.
go back to reference Semrad SD, Rose ML, Adams JL: Effect of tirilazad mesylate (U74006F) on eicosanoid and tumor necrosis factor generation in healthy and endotoxemic neonatal calves. Circ Shock 1993, 40: 235-242.PubMed Semrad SD, Rose ML, Adams JL: Effect of tirilazad mesylate (U74006F) on eicosanoid and tumor necrosis factor generation in healthy and endotoxemic neonatal calves. Circ Shock 1993, 40: 235-242.PubMed
37.
go back to reference Bahrami S, Redl H, Leichtfried G, Yu Y, Schlag G: Similar cytokine but different coagulation responses to lipopolysaccharide injection in D-galactosamine-sensitized versus nonsensitized rats. Infect Immun 1994, 62: 99-105.PubMedCentralPubMed Bahrami S, Redl H, Leichtfried G, Yu Y, Schlag G: Similar cytokine but different coagulation responses to lipopolysaccharide injection in D-galactosamine-sensitized versus nonsensitized rats. Infect Immun 1994, 62: 99-105.PubMedCentralPubMed
38.
go back to reference Jorres A, Dinter H, Topley N, Gahl GM, Frei U, Scholz P: Inhibition of tumour necrosis factor production in endotoxin-stimulated human mononuclear leukocytes by the prostacyclin analogue iloprost: cellular mechanisms. Cytokine 1997, 9: 119-125. 10.1006/cyto.1996.0145CrossRefPubMed Jorres A, Dinter H, Topley N, Gahl GM, Frei U, Scholz P: Inhibition of tumour necrosis factor production in endotoxin-stimulated human mononuclear leukocytes by the prostacyclin analogue iloprost: cellular mechanisms. Cytokine 1997, 9: 119-125. 10.1006/cyto.1996.0145CrossRefPubMed
39.
go back to reference Perretti M, Duncan GS, Flower RJ, Peers SH: Serum corticosterone, interleukin-1 and tumour necrosis factor in rat experimental endotoxaemia: comparison between Lewis and Wistar strains. Br J Pharmacol 1993, 110: 868-874.PubMedCentralCrossRefPubMed Perretti M, Duncan GS, Flower RJ, Peers SH: Serum corticosterone, interleukin-1 and tumour necrosis factor in rat experimental endotoxaemia: comparison between Lewis and Wistar strains. Br J Pharmacol 1993, 110: 868-874.PubMedCentralCrossRefPubMed
Metadata
Title
Effects of dopexamine on the intestinal microvascular blood flow and leucocyte activation in a sepsis model in rats
Authors
Jürgen Birnbaum
Edda Klotz
Claudia D Spies
Björn Lorenz
Patrick Stuebs
Ortrud Vargas Hein
Matthias Gründling
Dragan Pavlovic
Taras Usichenko
Michael Wendt
Wolfgang J Kox
Christian Lehmann
Publication date
01-08-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5011

Other articles of this Issue 4/2006

Critical Care 4/2006 Go to the issue