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Effects of norepinephrine on the renal vasculature in normal and endotoxemic dogs.

Bellomo, R and Kellum, JA and Wisniewski, SR and Pinsky, MR (1999) Effects of norepinephrine on the renal vasculature in normal and endotoxemic dogs. Am J Respir Crit Care Med, 159 (4 Pt 1). 1186 - 1192. ISSN 1073-449X

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Abstract

Septic shock is often complicated by systemic hypotension despite normal or increased cardiac output. Restoration of arterial pressure usually requires the administration of systemic vasopressor agents, such as norepinephrine. However, because norepinephrine induces vasoconstriction in other vascular beds, it may decrease visceral blood flow, impairing visceral organ function. Because sepsis is often associated with impaired peripheral vascular responsiveness, we hypothesized that, unlike in normal circulatory conditions, norepinephrine would improve visceral organ blood flow in sepsis by selectively increasing organ perfusion pressure. Thus, in nine pentobarbital-anesthetized, mechanically ventilated dogs, we measured the effect of norepinephrine infusion (0.3 microgram/kg/min) on renal, hepatic, and portal steady-state pressure-flow relations (P/Q) and the dynamic vascular P/Q, created by transient inferior vena caval occlusion, under basal and endotoxic conditions. Norepinephrine increased organ perfusion pressures during both control and endotoxemic conditions. However, even after controlling for the pressure effect using a general linear model, NE was associated with an increase in renal blood flow both before and after endotoxin administration. We conclude that, unlike the effects of administering norepinephrine under baseline conditions, norepinephrine infusion during endotoxic shock actually increases renal blood flow and that this effect is not the result of an increase in perfusion pressure alone.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Bellomo, R
Kellum, JAkellum@pitt.eduKELLUM0000-0003-1995-2653
Wisniewski, SRwisniew@edc.pitt.eduSTEVEWIS
Pinsky, MRpinsky@pitt.eduPINSKY
Date: April 1999
Date Type: Publication
Journal or Publication Title: Am J Respir Crit Care Med
Volume: 159
Number: 4 Pt 1
Page Range: 1186 - 1192
DOI or Unique Handle: 10.1164/ajrccm.159.4.9802055
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
Uncontrolled Keywords: Animals, Blood Pressure, Constriction, Dogs, Endotoxemia, Male, Norepinephrine, Portal Vein, Renal Circulation, Vasoconstrictor Agents, Vena Cava, Inferior
ISSN: 1073-449X
PubMed ID: 10194164
Date Deposited: 13 Mar 2012 14:36
Last Modified: 30 Oct 2018 13:56
URI: http://d-scholarship.pitt.edu/id/eprint/11318

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