Effects of norepinephrine during intra-abdominal hypertension on renal blood flow in bacteremic dogs

Critical Care Medicine
Zhi Y PengAnthony M-H Ho

Abstract

Intraabdominal hypertension reduces organ blood flow. Restoring abdominal perfusion pressure (APP) may restore renal blood flow, especially when sepsis is present. The effects of intra-abdominal pressure (IAP), followed by restoration of APP with norepinephrine, on renal blood flow were determined. Longitudinal study with bacteremia after nonbacteremic (control) conditions. University animal laboratory. Ten anesthetized mongrel dogs. IAP was raised to 10, 20, and 30 mm Hg, using intra-abdominal bags filled with saline. After each intervention, decompression was achieved by emptying the bag. Bacteremia was induced by injection of Escherichia coli. Cardiac output and renal blood flow were measured using surgically placed flow probes. Norepinephrine infusion was used to restore the mean arterial pressure to baseline at each IAP. A hypervolemic circulation was maintained throughout by infusing saline. Induction of bacteremia resulted in significant decreases in blood pressure, cardiac output, and renal blood flow (p < .01). Serial increases in IAP decreased cardiac output and renal blood flow both in control and bacteremic dogs (p < .001). These decreases were substantially corrected by abdominal decompression. In nonbacteremic con...Continue Reading

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