Alterations in forearm vascular reactivity in patients with septic shock

Anaesthesia
P KienbaumJ Peters

Abstract

Patients with septic shock are haemodynamically unstable and suffer from vasodilation. Studying the human forearm vascular bed in patients with septic shock, we tested the hypothesis that the responses to regionally infused endothelium-(in)dependent vasodilators and vasoconstrictors are uniformly impaired. Forearm blood flow (FBF, venous occlusion plethysmography) and brachial arterial pressure were determined to calculate forearm vascular resistance (FVR) in eight consecutive sedated, mechanically ventilated patients with septic shock (APACHE II Score range 21-34, SOFA Score 11-16) and 11 healthy volunteers. Despite increased baseline FBF in patients with septic shock (6.1 (SD 1.5) ml x min(-1) x (100 ml of tissue)(-1) compared to 4.7 (1.4) in volunteers) the significant decreases in FVR seen in response to exogenous nitric oxide (nitroprusside) and acetylcholine did not differ between groups. However, compared to volunteers, mitigation of endogenous nitric oxide production by a low dose of N(G)-methyl-L-arginine acetate (L-NMMA) caused a significant increase (+6.7 mmHg x min x ml(-1)) in septic patients. Regional vasoconstriction in response to phenylephrine (FVR: +9.9 vs +30.7 mmHg x min x ml(-1) in controls) and angiotensin...Continue Reading

References

Jan 1, 1994·Cardiovascular Research·A PetrosP Vallance
Nov 4, 1993·The New England Journal of Medicine·R G KilbournS S Gross
Feb 1, 1995·Critical Care Medicine·J Gómez-JiménezS Moncada
May 20, 1993·The New England Journal of Medicine·J E Parrillo
Oct 1, 1996·Journal of Veterinary Pharmacology and Therapeutics·L L Donaldson, A K Myers
Oct 21, 1999·The Journal of Trauma·M B MalayR N Townsend
Aug 18, 2001·Hypertension·M BucherA Kurtz
Sep 1, 2001·The New England Journal of Medicine·D W Landry, J A Oliver
Jan 15, 2002·Arteriosclerosis, Thrombosis, and Vascular Biology·Johannes PleinerMichael Wolzt
Mar 2, 2002·Anesthesiology·Bhavesh M PatelKeith R Walley
May 7, 2002·Critical Care Medicine·Tarek SharsharDjillaii Annane
Jul 1, 1953·The Journal of Physiology·R J WHITNEY
Jun 21, 2005·American Journal of Physiology. Heart and Circulatory Physiology·Friedrich MittermayerMichael Wolzt
Sep 27, 2005·Physiological Reviews·Nina Wettschureck, Stefan Offermanns

❮ Previous
Next ❯

Citations

Mar 13, 2010·Journal of Cardiovascular Pharmacology·Annelies DraismaPeter Pickkers
Sep 7, 2011·Critical Care : the Official Journal of the Critical Care Forum·James A Russell
Jan 5, 2011·Critical Care Medicine·Julia Wendon
May 27, 2011·Critical Care Medicine·Csaba Szabo, Brahm Goldstein
Aug 14, 2008·Anaesthesia·L T van EijkP Pickkers
Apr 16, 2013·Neurological Research·Carla S JungVolker Seifert
May 7, 2014·BioMed Research International·Sabrina H van IersselViviane M Conraads
Oct 19, 2017·Clinical Hemorheology and Microcirculation·Nivin SharawyChristian Lehmann
Jul 5, 2017·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·J GrevenH C Pape
Feb 25, 2021·Shock·Mariane C G Leite-AvalcaChristian Lehmann

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.