Effect of Epinephrine on Pressure, Flow, and Volume Relationships in the Systemic Circulation of Dogs

Caldini, Paolo; Permutt, Solbert; Waddell, J. Aubrey; Riley, Richard L.

doi:10.1161/01.res.34.5.606

Cited by 186 publications

(96 citation statements)

References 26 publications

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“…On the basis of animal experiments, 38 it seems likely that arteriolar vasodilation of muscles is analogous to opening an arteriovenous fistula. In contrast to the short time constant for venous drainage of the skeletal muscles, the splanchnic bed has a long time constant for venous drainage.…”

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confidence: 99%

Systemic and regional hemodynamics in patients with salt-sensitive hypertension.

1990

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Twenty-two patients with normal plasma renln and essential hypertension were classified as "salt-sensitive" (SS) (n=9) or "non-salt-sensitive" (NSS) (n=13) from an increase in mean blood pressure with changes in sodium intake from 25 to 250 meq/day. With the high sodium diet, the SS patients gained more weight (/?<0.05), retained more sodium (/><0.05), and had a greater increase in cardiac output (/?<0.05). Despite the markedly increased cardiac output, systemic vascular resistance did not change with sodium loads in the SS patients, whereas the NSS patients had a significant decrease in systemic vascular resistance. Thus, the greater increase in blood pressure with sodium loads in SS patients can be attributed not only to an increase in cardiac output, possibly resulting from greater sodium retention, but also to inappropriately elevated systemic vascular resistance. Concomitant with a greater increase in cardiac output, the SS patients had a greater increase in forearm blood flow with sodium loading than the NSS patients (p<0.02). In contrast, blood flow to the kidney and the liver was not significantly changed in either group; renal (p<0.05) and hepatic (/><0.01) vascular resistance increased significantly in SS patients but remained unchanged in NSS patients. Thus, evidence presented suggests that the greater increase in blood pressure with sodium loads seems to be characterized by a very inhomogenous distribution of local flow and resistance in SS patients; renal and hepatic blood flow remains essentially unchanged and skeletal muscle blood flow receives almost all of the increase in cardiac output Moreover, systemic vascular resistance changes did not reflect the resistance of individual beds because vasoconstriction appeared in the kidney and the splanchnic area but was masked by prominent vasodilation in the skeletal muscle. Because this hemodynamic pattern is similar to the pattern evoked during defense reaction, it is suggested that sympathetic overactivity on a selective basis might be involved in the impaired renal function for sodium excretion and the increase in blood pressure with sodium loads in SS patients. (Hypertension 1990,16:235-244)

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confidence: 99%

Systemic and regional hemodynamics in patients with salt-sensitive hypertension.

1990

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“…Considering the larger part played by the increase in cardiac output rather than that inn peripheral resistance, a possible difference in capacitance section between NCR and SHR may be worthy of special note. However, the marked increase in cardiac output in transposition response in SHR may be a secondary effect of the above stated marked increase in peripheral resistance in the splanchnic area, if this area is one of the main components of the slow-time constant area as postulated by CALDINI et al (1974), which drains a large amount of blood to the systemic circulation on infusion of adrenaline. It has been shown that the major component of transposition response is splanchnic vasoconstriction and muscle vasodilatation induced by adrenaline release from the adrenal medulla (IRIucHIJIMA et a!., 1982).…”

Section: Discussionmentioning

confidence: 99%

Regional blood flow in conscious spontaneously hypertensive rats.

Iriuchijima

1983

Jpn.J.Physiol

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In spontaneously hypertensive and normal control rats in the conscious state, blood flow was observed in the carotid artery, superior mesenteric artery, renal artery, and terminal aorta with a chronically implanted electromagnetic flow probe. At rest, flow per body weight was not different between the two groups except at the terminal aorta where it was significantly smaller in hypertensive rats (P<0.05).Regional peripheral resistance was higher in hypertensive rats than in normal rats in all the four arteries, but its elevation in the former was not uniform but most marked in the hindquarter area supplied by the terminal aorta. Quantitatively, this area was estimated to contribute about 40% of the total conductance decrease in hypertensive rats in comparison with the control. This suggests the importance of elevation of resistance in muscle blood vessels in hypertension. The contributions from the superior mesenteric area and the bilateral kidneys were estimated to be about 15 % each. In the transposition response induced by transposing rats from their home cage to a new cage, the increase in hindquarter flow was significantly greater in hypertensive rats than in normal rats (P<0.01).The sum of the mean flows of the four arteries, a measure of cardiac output, was not different between hypertensive and normal rats at rest but greater in the former during transposition response. Elevation of arterial pressure in the response in hypertensive rats but not in the normal rats was ascribable largely to a greater increase in cardiac output in the former than the latter.

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“…In these studies, the venoconstriction generated by noradrenaline recruits part of the unstressed volume into the stressed volume, due to small changes in venous compliance (57)(58)(59). This mechanism allows a transfer of blood volume from the splanchnic beds to the heart increasing right ventricular filling (60)(61)(62). (65) studied the effects of noradrenaline infusions on cardiac output in sixteen postoperative cardiac surgical patients using an increase of 20 mmHg in MAP as a target.…”

Section: For Blood Pressurementioning

confidence: 99%

Perioperative Haemodynamic Optimisation

Aya¹,

Cecconi²,

Rhodes³

2014

Turk J Anesth Reanim

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56During the latest years, a number of studies have confirmed the benefits of perioperative haemodynamic optimisation on surgical mortality and postoperative complication rate. This process requires the use of advanced haemodynamic monitoring with the purpose of guiding therapies to reach predefined goals. This review aim to present recent evidence on perioperative goal directed therapy (GDT), with an emphasis in some aspects that may merit further investigation. In order to maximise the benefits on outcomes, GDT must be implemented as early as possible; intravascular volume optimisation should be in accordance with the response of the preload-reserve, goals should be individualised and adequacy of the intervention must be also assessed; non-invasive or minimally invasive monitoring should be used and, finally, side effects of every therapy should be taken into account in order to avoid undesired complications. New drugs and technologies, particularly those exploring the venous side of the circulation, may improve in the future the effectiveness and facilitate the implementation of this group of therapeutic interventions.

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Effect of Epinephrine on Pressure, Flow, and Volume Relationships in the Systemic Circulation of Dogs

Cited by 186 publications

References 26 publications

Systemic and regional hemodynamics in patients with salt-sensitive hypertension.

Systemic and regional hemodynamics in patients with salt-sensitive hypertension.

Regional blood flow in conscious spontaneously hypertensive rats.

Perioperative Haemodynamic Optimisation

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