The systemic and regional hemodynamic effects of phenylephrine in sheep under normal conditions and during early hyperdynamic sepsis

Anesthesia and Analgesia
Hiroshi MorimatsuRinaldo Bellomo

Abstract

Phenylephrine treatment of hypotension in sepsis raises concern because it may decrease vital organ bloodflow. Accordingly, we investigated the effects of phenylephrine on systemic and regional bloodflow in normal and septic sheep. Responses to phenylephrine or vehicle infusion for 6 hours were determined in conscious normal sheep and sheep with early sepsis induced by administration of live Escherichia coli. Cardiac output and coronary, mesenteric, and renal bloodflow were measured with implanted flow probes. In normal sheep, phenylephrine decreased cardiac output and heart rate (HR) but increased stroke volume and mean arterial blood pressure (MAP) (84 ± 6 to 108 ± 6 mm Hg, magnitude of mean difference [diff.] 19 [22.6%]; 95% confidence intervals [CI], 17-21). There were significant decreases in regional conductance values with a transient decrease in mesenteric bloodflow, no change in coronary bloodflow, and increased renal bloodflow (222 ± 53 to 271 ± 55 mL/min; diff. 31 [13.9%]; 95% CI, 26-36). During hyperdynamic sepsis, vasodilatation and increased bloodflow occurred in all vascular beds. Phenylephrine restored MAP and stroke volume to baseline values, but HR, cardiac output, and total peripheral conductance progressivel...Continue Reading

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Citations

Jul 16, 2013·Critical Care : the Official Journal of the Critical Care Forum·Antoine G SchneiderRinaldo Bellomo
Apr 9, 2013·Intensive Care Medicine·Neng F KurniatiMatijs van Meurs
Mar 13, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Paolo CalzavaccaRinaldo Bellomo
Jul 17, 2016·Interactive Cardiovascular and Thoracic Surgery·Ivancarmine GambardellaLeonard N Girardi
Sep 8, 2012·Current Opinion in Critical Care·John ProwleRinaldo Bellomo
Mar 22, 2013·Critical Care : the Official Journal of the Critical Care Forum·Antione G SchneiderRinaldo Bellomo
Jun 26, 2014·Expert Review of Proteomics·Jorien De LoorEvelyne Meyer

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