Circuit factors in the high cardiac output of sepsis

Journal of Critical Care
S Magder, G Vanelli

Abstract

The increase of cardiac output (CO) in sepsis must be matched by an increase in venous return. Our goal was to determine which of the determinants of venous return are responsible in volume-loaded and nonvolume-loaded pigs with endotoxemia. The determinants include stressed volume, venous compliance (Cv), venous resistance (RVR) and right atrial pressure (Pra). We also tested the effect of the nitric oxide (NO) synthase inhibitor, N omega-nitro-L-arginine-methyl ester (L-NAME) after the hemodynamics with endotoxin stabilized. Pigs were anesthetized and mechanically ventilated. We measured CO by thermodilution, mean circulatory filling pressure (MCFP) by inflating a balloon in the right atrium, blood volume by dye dilution, and Cv by rapid blood infusions. RVR was calculated from MCFP-Pra/CO). After baseline measurements, we infused 10 micrograms/(kg x h-1) of Escherichia coli endotoxin. Eight animals also received 30 mL x kg-1 of dextran over the 2 hours (volume treated), and seven did not (no volume). After 2 hours we injected 25 mg x kg-1 of the NO synthase inhibitor, L-NAME, and repeated the measurements. In volume-treated animals, CO increased from 3.9 +/- 0.7 to 5.4 +/- 0.8 L x min-1 (P < .05), and blood pressure (BP) fell...Continue Reading

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Citations

Dec 18, 2001·Pharmacology & Therapeutics·F FeihlL Liaudet
Dec 1, 1996·Journal of Critical Care·R F Lodato
Dec 30, 1998·Journal of Critical Care·S Magder, M Rastepagarnah
Jun 8, 2010·American Journal of Physiology. Heart and Circulatory Physiology·Li JianhuiLucas Liaudet
Dec 10, 1999·American Journal of Respiratory and Critical Care Medicine·P Datta, S Magder
Mar 31, 2015·International Journal of Molecular Sciences·Sheldon MagderImad Al Ghouleh
Mar 13, 1999·Critical Care Medicine·S MehtaS Magder
Sep 11, 1998·Journal of Cardiovascular Pharmacology·S Magder, K Kabsele
Jan 7, 2000·Anesthesia and Analgesia·P T MurrayJ G Umans

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