Vasopressin impairs brain, heart and kidney perfusion: an experimental study in pigs after transient myocardial ischemia

Müller, Stig; How, Ole-Jakob; Hermansen, Stig Eggen; Stenberg, Thor Allan; Sager, Georg; Myrmel, Truls

doi:10.1186/cc6794

Cited by 43 publications

(33 citation statements)

References 39 publications

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“…Our findings are consistent with those reported by others [15, 21] that AVP-induced decrease of myocardial contractility is most likely due to a decreased CF. However, there was a lack of correlation between CF and corresponding decrease in LVDP and RPP induced by 0.2, U/L AVP in the early-stage endotoxemia, although positive correlation between CF and RPP in the late-stage was found (Figure 5(a)).…”

Section: Discussionsupporting

confidence: 94%

Oroxylin A, but Not Vasopressin, Ameliorates Cardiac Dysfunction of Endotoxemic Rats

Liu

Chen

Tseng

et al. 2012

Evidence-Based Complementary and Alternative Medicine

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The mortality in septic patients with myocardial dysfunction is higher than those without it. Beneficial effects of flavonoid oroxylin A (Oro-A) on endotoxemic hearts were evaluated and compared with that of arginine vasopressin (AVP) which is used to reverse hypotension in septic patients. Endotoxemia in rats was induced by one-injection of lipopolysaccharides (LPS, 10 mg/kg, i.p.), and hearts were isolated 5-hrs or 16-hrs later. Isolated hearts with constant-pressure or constant-flow mode were examined by Langendorff technique. Rate and force of contractions of isolated atrial and ventricular strips were examined by tissue myography. Isolated endotoxemic hearts were characterized by decreased or increased coronary flow (CF) in LPS-treated-for-5hr and LPS-treated-for-16-hr groups, respectively, with decreased inotropy in both groups. Oro-A-perfusion ameliorated while AVP-perfusion worsened the decreased CF and inotropy in both preparations. Oro-A and AVP, however, did not affect diminished force or rate of contraction of atrial and ventricular strips of endotoxemic hearts. Oro-A-induced CF increase was not affected following coronary endothelium-denudation with saponin. These results suggest that Oro-A ameliorates LPS-depressed cardiac functions by increasing CF, leading to positive inotropy. In contrast, AVP aggravates cardiac dysfunction by decreasing CF. Oro-A is a potentially useful candidate for treating endotoxemia complicated with myocardial dysfunction.

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Section: Discussionsupporting

confidence: 94%

Oroxylin A, but Not Vasopressin, Ameliorates Cardiac Dysfunction of Endotoxemic Rats

Liu

Chen

Tseng

et al. 2012

Evidence-Based Complementary and Alternative Medicine

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“…29 AVP has been used in piglet models and is still an effective agent for achieving arterial hypertension. 26,29,41,42 …”

Section: Discussionmentioning

confidence: 99%

The Anesthetic Effects on Vasopressor Modulation of Cerebral Blood Flow in an Immature Swine Model

Bruins

Kilbaugh

Margulies

et al. 2013

Anesthesia &Amp; Analgesia

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Background The effect of various sedatives and anesthetics on vasopressor modulation of cerebral blood flow (CBF) in children is unclear. In adults, isoflurane has been described to decrease CBF to a lesser extent than fentanyl and midazolam. Most large animal models of neurocritical care use inhaled anesthetics for anesthesia. Investigations involving modulations of CBF would have improved translatability within a model that more closely approximates the current practice in the pediatric intensive care unit. Methods Fifteen (15) four-week-old piglets were given one of 2 anesthetic protocols: total IV anesthesia (TIVA) (midazolam 1 mg/kg/hr and fentanyl 100 mcg/kg/hr, N=8) or ISO (isoflurane 1.5–2% and fentanyl 100 mcg/kg/hr, N=7). Mean arterial blood pressure, intracranial pressure (ICP), CBF, and brain tissue oxygen tension were measured continuously as piglets were exposed to escalating doses of arginine vasopressin, norepinephrine (NE) and phenylephrine (PE). Results Baseline CBF was similar in two groups (ISO 38±10 vs. TIVA 35±26 ml/100gm/min) despite lower baseline cerebral perfusion pressure in the ISO group, 45±11 vs. 71±11 mmHg (p< 0.0005). Piglets in ISO group displayed increases in ICP with PE and NE (11±4 vs. 16±4 mmHg and 11±8 vs. 18±5 mmHg; p< 0.05), but in the TIVA group only exposure to PE resulted in increases in ICP when comparing maximal dose values to baseline data (11±4 vs. 15±5 mmHg; p < 0.05). Normalized CBF displayed statistically significant increases with regards to anesthetic group and vasopressor dose when piglets were exposed to NE and PE (p < 0.05), suggesting an impairment of autoregulation within ISO, but not TIVA. Conclusion The vasopressor effect on CBF was limited when using a narcotic-benzodiazepine-based anesthetic protocol compared to volatile anesthetics, consistent with a preservation of autoregulation. Selection of anesthetic drugs is critical to investigate mechanisms of cerebrovascular hemodynamics, and in translating critical care investigations between the laboratory and bedside.

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“…This hypothesis was supported by studies demonstrating benefits of exogenous AVP administration in MABP recovery following HS (22). While these studies suggest an important role for AVP in response to HS and indicate therapeutic potential for exogenous administration, pressor use can lead to complications including impaired organ perfusion (23, 24). Thus, we sought a physiologic approach to stimulate endogenous AVP release following HS during AAI.…”

Section: Discussionmentioning

confidence: 99%

Hypertonic saline resuscitation enhances blood pressure recovery and decreases organ injury following hemorrhage in acute alcohol intoxicated rodents

Su¹,

Whitaker²,

Molina³

2013

Journal of Trauma and Acute Care Surgery

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Background Acute alcohol intoxication (AAI) impairs the hemodynamic and arginine vasopressin (AVP) counter-regulation to hemorrhagic shock (HS) and lactated Ringer’s (LR) fluid resuscitation (FR). The mechanism of AAI-induced suppression of AVP release in response to HS involves accentuated nitric oxide (NO) inhibitory tone. In contrast, AAI does not prevent AVP response to increased osmolarity produced by hypertonic saline (HTS) infusion. We hypothesized that FR with HTS during AAI would enhance AVP release by decreasing PVN NO inhibitory tone subsequently improving mean arterial blood pressure (MABP) and organ perfusion. Methods Male Sprague Dawley rats received a 15h alcohol infusion (2.5g/kg + 0.3 g/kg/h) or dextrose (DEX) prior to HS (40mmHg × 60 min) and FR with HTS (7.5%; 4ml/kg) or LR (2.4 × blood volume removed). Organ blood flow was determined and brains collected for NO content at 2h post-FR. Results HTS improved MABP recovery in AAI (109 vs 80mmHg) and DEX (114 vs 83mmHg) animals compared to LR. This was associated with higher (>60%) circulating AVP levels at 2h post-FR than those detected in LR animals in both groups. Neither AAI alone nor HS in DEX animals resuscitated with LR altered organ blood flow. In AAI animals, HS and FR with LR reduced blood flow to liver (72%), small intestine (65%), and large intestine (67%) compared to shams. FR with HTS improved liver (3-fold) and small intestine (2-fold) blood flow compared to LR in AAI-HS animals. The enhanced MABP response to HTS was prevented by pretreatment with a systemic AVP V1a receptor antagonist. HTS decreased PVN NO content in both groups 2h post-FR. Conclusions These results suggest that FR with HTS in AAI results in removal of central NO inhibition of AVP, restoring AVP levels and improving MABP and organ perfusion in AAI-HS.

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Vasopressin impairs brain, heart and kidney perfusion: an experimental study in pigs after transient myocardial ischemia

Cited by 43 publications

References 39 publications

Oroxylin A, but Not Vasopressin, Ameliorates Cardiac Dysfunction of Endotoxemic Rats

Oroxylin A, but Not Vasopressin, Ameliorates Cardiac Dysfunction of Endotoxemic Rats

The Anesthetic Effects on Vasopressor Modulation of Cerebral Blood Flow in an Immature Swine Model

Hypertonic saline resuscitation enhances blood pressure recovery and decreases organ injury following hemorrhage in acute alcohol intoxicated rodents

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