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Intensive Care Medicine

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01-07-2008 | Experimental

Systemic and hepatosplanchnic macro- and microcirculatory dose response to arginine vasopressin in endotoxic rabbits

Authors: Tal Kopel, Marie-Reine Losser, Valérie Faivre, Didier Payen

Published in: Intensive Care Medicine | Issue 7/2008

Abstract

Objective

Arginine vasopressin (AVP) is being used increasingly to treat vasodilatory hypotension, although its effects on hepatosplanchnic perfusion have been debated.

Design

Prospective study in a university-based experimental research laboratory.

Subjects and interventions

We compared the effect of AVP on systemic, gut, and liver blood flow in anesthetized and ventilated rabbits given either saline or endotoxin. Incremental i.v. boluses of AVP ranging from 1 to 1,000 ng were administered 90 min post-endotoxin or saline.

Measurements and results

Endotoxin induced a shock state with a transient decrease of mesenteric artery blood flow velocity (pulsed Doppler, in centimeters per second, V_mes) but had no effect on liver surface microcirculation (laser Doppler in TPU, MicroFl_liver). Gut microcirculatory (MicroFl_gut) changes became independent of mean arterial pressure (MAP) after endotoxin. In control rabbits (n = 5), increasing doses of AVP elevated MAP but reduced aortic blood flow (pulsed Doppler, VAo), V_mes, and MicroFl_gut (p < 0.05). In endotoxic animals (n = 6), AVP produced a similar rise in MAP (p < 0.05), while V_mes and MicroFl_gut only decreased for AVP doses above 100 ng (p < 0.05). Liver microcirculation was only minimally affected by AVP, although significantly, both in control and endotoxin animals.

Conclusion

Preservation of mesenteric blood flow as well as gut and liver microcirculation, with therapeutic doses of AVP during endotoxemia, supports its use as a hemodynamic agent during septic shock.

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Title: Systemic and hepatosplanchnic macro- and microcirculatory dose response to arginine vasopressin in endotoxic rabbits
Authors: Tal Kopel
Marie-Reine Losser
Valérie Faivre
Didier Payen
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1058-z

At a glance: The STEP trials

Springer Medicine

Systemic and hepatosplanchnic macro- and microcirculatory dose response to arginine vasopressin in endotoxic rabbits

Abstract

Objective

Design

Subjects and interventions

Measurements and results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Design

Subjects and interventions

Measurements and results

Conclusion

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