Vasopressors and intestinal mucosal perfusion after cardiac surgery: Norepinephrine vs. phenylephrine

Critical Care Medicine
Andreas NygrenS E Ricksten

Abstract

To evaluate the potential differential effects of norepinephrine, an alpha1-, beta1-, and beta2-receptor agonist, to the alpha1-agonist phenylephrine on jejunal mucosal perfusion, gastric-arterial PCO2 gradient, and the global splanchnic oxygen demand-supply relationship after cardiac surgery. A randomized, prospective, interventional crossover study. A university cardiothoracic intensive care unit. Ten patients were studied during propofol sedation and mechanical ventilation after uncomplicated coronary artery bypass surgery. Each patient received randomly and sequentially norepinephrine (0.052+/-0.009 microg/kg/min) and phenylephrine (0.50+/-0.22 microg/kg/min) to increase mean arterial blood pressure by 30%. Data on jejunal mucosal perfusion, jejunal mucosal hematocrit, and red blood cell velocity (laser Doppler flowmetry) as well as gastric-arterial Pco2 gradient (tonometry) and splanchnic oxygen extraction were obtained before (control) and during a 30-min drug infusion period after the target mean arterial blood pressure was reached. The procedure was sequentially repeated for the second vasopressor. Both drugs induced a 40-46% increase in systemic vascular resistance with no change in cardiac index. Neither jejunal mucos...Continue Reading

References

Jun 1, 1975·The American Journal of Physiology·S F Glotzbach, H C Heller
Jun 1, 1976·The American Journal of Physiology·P H GuthE Smith
Jul 1, 1976·The Journal of Physiology·C V GreenwayJ Zink
Jun 1, 1992·Journal of Clinical Pharmacy and Therapeutics·C A Haffner, M J Kendall
Sep 1, 1986·Scandinavian Journal of Gastroenterology·H AhnO Lundgren
Sep 1, 1988·Canadian Journal of Physiology and Pharmacology·W W LauttL K Lockhart
Apr 1, 1988·The American Journal of Physiology·D A ArnallL B Oscai
Sep 1, 1993·Critical Care Medicine·E RuokonenE J Hansen
Jan 1, 1997·International Journal of Microcirculation, Clinical and Experimental·A Colantuoni, S Bertuglia
Sep 1, 2001·The New England Journal of Medicine·D W Landry, J A Oliver
Dec 5, 2002·Shock·Hermann EnsingerKarl Träger
May 23, 2003·Intensive Care Medicine·Hiroshi MorimatsuBrian Buxton
Jul 25, 2003·Intensive Care Medicine·Andreas NygrenSven-Erik Ricksten

❮ Previous
Next ❯

Citations

Sep 15, 2010·British Journal of Anaesthesia·W Hasibeder
Aug 30, 2014·Critical Care Nursing Clinics of North America·Daniel L Arellano, Sandra K Hanneman
Jul 4, 2012·Burns : Journal of the International Society for Burn Injuries·Anders SamuelssonFolke Sjöberg
Apr 13, 2011·Annales Françaises D'anesthèsie Et De Rèanimation·A DewitteG Janvier
Dec 18, 2016·Journal of Clinical Monitoring and Computing·H SørensenN H Secher
Jun 13, 2012·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Diana L Wells
Jan 23, 2014·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Shuofei YangJieshou Li
Dec 29, 2012·JPEN. Journal of Parenteral and Enteral Nutrition·Erin E Mancl, Katie M Muzevich
Oct 14, 2008·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Annie Widlicka
Dec 26, 2015·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Brandon R Bruns, Rosemary A Kozar
Apr 19, 2018·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·S M JansenS S Gisbertz
Apr 27, 2011·Anesthesia and Analgesia·Robert H ThieleCarl Lynch
Apr 27, 2011·Anesthesia and Analgesia·Robert H ThieleCarl Lynch
Oct 11, 2012·International Anesthesiology Clinics·Ximena SolerAmgad S Saied
Aug 16, 2019·Critical Care Medicine·Paul E Wischmeyer
Oct 16, 2007·Anaesthesia and Intensive Care·F M P van HarenJ G Van der Hoeven
Aug 15, 2017·Acta Anaesthesiologica Scandinavica·M FredholmS-E Ricksten
Jul 19, 2017·World Journal of Surgery·Henry HoffmannChristoph Kettelhack
Feb 10, 2021·Critical Care Nurse·Jan Powers
Apr 23, 2021·Anesthesia and Analgesia·W Brenton FrenchMichael J Scott
Apr 28, 2021·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·Alexander GräfitschHenry Hoffmann

❮ 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.