Effects of combined arginine vasopressin and levosimendan on organ function in ovine septic shock

Critical Care Medicine
Sebastian RehbergMartin Westphal

Abstract

To compare the effects of a first-line therapy of combined arginine vasopressin, levosimendan, and norepinephrine with arginine vasopressin + norepinephrine or norepinephrine alone in ovine septic shock. Prospective, randomized, controlled laboratory experiment. University animal research facility. Twenty-one chronically instrumented sheep. After the onset of fecal peritonitis-induced septic shock (mean arterial pressure <60 mm Hg), sheep were randomly assigned to receive first-line treatment with arginine vasopressin (0.5 mU·kg·min), combined arginine vasopressin (0.5 mU·kg·min) and levosimendan (0.2 μg·kg·min), or normal saline (each n = 7) for 24 hrs. In all groups, open-label norepinephrine was additionally titrated to maintain mean arterial pressure at 70 ± 5 mm Hg, if necessary. Arginine vasopressin + levosimendan + norepinephrine improved left ventricular contractility (higher stroke work indices at similar or lower preload) and pulmonary function (Pao2/Fio2 ratio) when compared with the other groups (p < .05 each). Both nonadrenergic treatment strategies reduced open-label norepinephrine doses. However, only arginine vasopressin + levosimendan + norepinephrine limited fluid requirements and positive fluid balance vs. bo...Continue Reading

References

May 20, 1993·The New England Journal of Medicine·J E Parrillo
Sep 1, 2001·The New England Journal of Medicine·D W Landry, J A Oliver
Nov 2, 2001·European Journal of Pharmacology·D M KopustinskieneN E Saris
Mar 2, 2002·Anesthesiology·Bhavesh M PatelKeith R Walley
May 15, 2002·Chest·William L Jackson, Andrew F Shorr
Aug 22, 2003·Critical Care : the Official Journal of the Critical Care Forum·Jean-Louis Vincent
Apr 7, 2005·Intensive Care Medicine·Andrea MorelliPaolo Pietropaoli
Nov 9, 2005·Critical Care Medicine·Günter LucknerBarbara Friesenecker
Jan 19, 2006·American Journal of Physiology. Renal Physiology·Richard A ZagerChristine K Abrass
Mar 2, 2006·Anesthesiology·Wolfgang G Toller, Christian Stranz
Oct 5, 2006·Intensive Care Medicine·François LauzierOlivier Lesur
Nov 30, 2006·Der Anaesthesist·S RehbergM Westphal
Apr 11, 2007·Critical Care Medicine·Martin WestphalHugo Van Aken
May 19, 2007·Shock·Doris Cunha-GoncalvesSten Blomquist
Sep 14, 2007·Acta Anaesthesiologica Scandinavica·F GuarracinoC Vullo
Sep 29, 2007·Critical Care Medicine·Zhen WangJean-Louis Vincent
Oct 19, 2007·Critical Care Medicine·Günter LucknerMartin W Dünser
Dec 26, 2007·Critical Care Medicine·R Phillip DellingerUNKNOWN World Federation of Societies of Intensive and Critical Care Medicine
Feb 29, 2008·The New England Journal of Medicine·James A RussellUNKNOWN VASST Investigators
Aug 8, 2008·Best Practice & Research. Clinical Anaesthesiology·Christian ErtmerMartin Westphal
Dec 4, 2008·Critical Care Medicine·Perenlei EnkhbaatarDaniel L Traber
Dec 4, 2008·Critical Care Medicine·Matthias LangePerenlei Enkhbaatar
Jul 14, 2009·Critical Care : the Official Journal of the Critical Care Forum·Florian SimonBalázs Hauser
Feb 4, 2010·JAMA : the Journal of the American Medical Association·Brenda R HemmelgarnUNKNOWN Alberta Kidney Disease Network

❮ Previous
Next ❯

Citations

Mar 8, 2011·Intensive Care Medicine·Karen Stuart-Smith
Sep 7, 2011·Critical Care : the Official Journal of the Critical Care Forum·James A Russell
Dec 25, 2010·Critical Care : the Official Journal of the Critical Care Forum·Andrea MorelliMartin Westphal
Aug 10, 2013·Cardiovascular Drugs and Therapy·Mehmet B YilmazGerhard Wikström
Nov 28, 2013·The Journal of Surgical Research·Liangming LiuTao Li
Nov 25, 2011·Kidney International·Jean-Louis Vincent, Daniel De Backer
Jun 25, 2015·Journal of Diabetes and Its Complications·Weiyi HuangGregory M Peterson
May 28, 2016·Clinics in Chest Medicine·Jean P Gelinas, James A Russell
Jan 12, 2016·Expert Opinion on Emerging Drugs·Nicholas HemingDjillali Annane
Sep 22, 2010·Critical Care Medicine·James A Russell
Aug 4, 2011·Expert Review of Anti-infective Therapy·Jean-Louis VincentAikaterina Dimoula
May 27, 2011·Critical Care Medicine·Jian-Jun YangYong G Peng
Jun 12, 2019·Annals of Intensive Care·Antoine GuillonUNKNOWN Translational Research Committee of the French Intensive Care Society (Société de Réanimation de Langue Française)
Jul 9, 2020·Journal of Cardiovascular Pharmacology·Zoltán PappPiero Pollesello
Aug 21, 2020·Seminars in Respiratory and Critical Care Medicine·James A RussellNiranjan Kissoon
Jan 31, 2012·Upsala Journal of Medical Sciences·Mu-Huo JiWei-Yan Li
Jul 9, 2020·Journal of Cardiovascular Pharmacology·Zoltán PappPiero Pollesello

❮ 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.