Acetaminophen Attenuates Pulmonary Vascular Resistance and Pulmonary Arterial Pressure and Inhibits Cardiovascular Collapse in a Porcine Model of Endotoxemia

Bergström, Anna; Lipcsey, Miklós; Larsson, Anders; Yang, Bei; Engblom, David; Chew, Michelle; Elander, Louise

doi:10.1097/shk.0000000000002061

Cited by 2 publications

(2 citation statements)

References 34 publications

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“…This study has some limitations. First, while it is plausible that PPV and SVV could be linked to changes in pulmonary vascular resistance induced by endotoxin infusion, as suggested by other authors (27), our study showed that CO remained constant during endotoxin infusion. This finding indicates that the impact of our endotoxin infusion protocol on PPV and SVV was relatively minimal.…”

Section: Discussionsupporting

confidence: 68%

Unveiling the Significance of Dynamic Arterial Elastance: An Insightful Approach to Assessing Arterial Load in an Endotoxin Shock Model

Alvarado Sánchez,

Caicedo Ruiz,

Diaztagle Fernández

et al. 2023

Shock

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Background: The aim of this study was to investigate the relationship between dynamic arterial elastance (EaDyn) and the pulsatile and steady components of arterial load in an endotoxin shock model using a two-element Windkessel model and to describe the behavior of EaDyn in this model. Methods: Ten female Yorkshire pigs were administered lipopolysaccharide intravenously to induce endotoxin shock, while three female pigs served as the control group. Measurements of EaDyn (ratio between pulse pressure variation and stroke volume variation), effective arterial elastance, arterial compliance (Cart), and systemic vascular resistance were taken every 30 min in the endotoxin group until shock was induced. In the control group, these variables were measured every 30 min for 3 h. Subsequently, a fluid load was administered to both groups, and measurements were repeated every 30 min. After 1 hour of shock induction, the endotoxin group was divided into two subgroups: one receiving norepinephrine (END-NE) and the other not receiving it (END-F). Results: EaDyn showed an association with Cart, while pulse pressure variation was connected to both pulsatile and steady components, and stroke volume variation was solely associated with steady components. In addition, EaDyn exhibited higher values in the END groups than in the control group when shock was achieved. Furthermore, after the administration of norepinephrine, EaDyn displayed higher values in END-F than in END-NE. Conclusions: The EaDyn variable helps identify changes in the pulsatile component of arterial load, providing valuable guidance for management strategies aimed at improving cardiac performance.

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Section: Discussionsupporting

confidence: 68%

Unveiling the Significance of Dynamic Arterial Elastance: An Insightful Approach to Assessing Arterial Load in an Endotoxin Shock Model

Alvarado Sánchez,

Caicedo Ruiz,

Diaztagle Fernández

et al. 2023

Shock

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“…In lab tests, some studies have suggested that acetaminophen eases sepsis-induced cognitive impairment by reducing iron-induced cell death via the GPX4 and FSP1 signal pathways ( 43 , 44 ). Other research hints that it reduces the effect of endotoxins on pulmonary circulation in sedated pigs, which could be crucial in severe systematic inflammation ( 45 ). Moreover, the CYP3A5 gene has been proposed as a potential significant biomarker for acetaminophen metabolism.…”

Section: Discussionmentioning

confidence: 99%

Association between acetaminophen administration and clinical outcomes in patients with sepsis admitted to the ICU: a retrospective cohort study

Sun,

Liu,

Liang

et al. 2024

Front. Med.

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BackgroundSepsis, affecting over 30 million people worldwide each year, is a key mortality risk factor in critically ill patients. There are significant regional discrepancies in its impact. Acetaminophen, a common over-the-counter drug, is often administered to control fever in suspected infection cases in intensive care units (ICUs). It is considered generally safe when used at therapeutic levels. Despite its widespread use, there’s inconsistent research regarding its efficacy in sepsis management, which creates uncertainties for ICU doctors about its possible advantages or harm. To address this, we undertook a retrospective cohort study utilizing the MIMIC-IV database to examine the correlation between acetaminophen use and clinical outcomes in septic patients admitted to the ICU.MethodsWe gathered pertinent data on sepsis patients from the MIMIC-IV database. We used propensity score matching (PSM) to pair acetaminophen-treated patients with those who were not treated. We then used Cox Proportional Hazards models to examine the relationships between acetaminophen use and factors such as in-hospital mortality, 30-day mortality, hospital stay duration, and ICU stay length.ResultsThe data analysis involved 22,633 sepsis patients. Post PSM, a total of 15,843 patients were matched; each patient not receiving acetaminophen treatment was paired with two patients who received it. There was a correlation between acetaminophen and a lower in-hospital mortality rate (HR 0.443; 95% CI 0.371–0.530; p < 0.001) along with 30-day mortality rate (HR 0.497; 95% CI 0.424–0.583; p < 0.001). Additionally, it correlated with a decrease in the duration of hospitalization [8.4 (5.0, 14.8) vs. 9.0 (5.1, 16.0), p < 0.001] and a shorter ICU stay [2.8 (1.5, 6.0) vs. 3.1 (1.7, 6.5); p < 0.05].ConclusionThe use of acetaminophen may lower short-term mortality in critically ill patients with sepsis. To confirm this correlation, future research should involve multicenter randomized controlled trials.

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Acetaminophen Attenuates Pulmonary Vascular Resistance and Pulmonary Arterial Pressure and Inhibits Cardiovascular Collapse in a Porcine Model of Endotoxemia

Cited by 2 publications

References 34 publications

Unveiling the Significance of Dynamic Arterial Elastance: An Insightful Approach to Assessing Arterial Load in an Endotoxin Shock Model

Unveiling the Significance of Dynamic Arterial Elastance: An Insightful Approach to Assessing Arterial Load in an Endotoxin Shock Model

Association between acetaminophen administration and clinical outcomes in patients with sepsis admitted to the ICU: a retrospective cohort study

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