Abstract |
Hepato-splanchnic metabolic activity is seen to be related to regional blood flow and oxygen/substrate availability in patients with sepsis. Catecholamines, which may modulate metabolic activity perse, are common to stabilize hemodynamics. We studied the effect of a dopexamine-induced increase in splanchnic blood flow (Qspl) on regional metabolic rate in 10 patients with septic shock requiring norepinephrine to maintain mean arterial pressure (>60 mmHg). Splanchnic blood flow was determined using the indocyanine-green method with hepatic venous sampling. We determined the hepato-splanchnic lactate, pyruvate, alanine, and glutamine turnover and the lactate/ pyruvate and ketone body ratio as well as the endogenous glucose production (EGP) using the stable isotope approach. Qspl increased from 0.86 (0.79-1.15) to 0.96 (0.92-1.33) L/min/m2, not influencing any parameter of metabolic activity. We speculate that this finding is due to altered beta-adrenoreceptor-mediated thermogenic effects due to the interplay of different beta- sympathomimetics at the receptor site.
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Authors | P Kiefer, I Tugtekin, H Wiedeck, J Vogt, U Wachter, H Bracht, G Geldner, M Georgieff, P Radermacher |
Journal | Shock (Augusta, Ga.)
(Shock)
Vol. 15
Issue 6
Pg. 427-31
(Jun 2001)
ISSN: 1073-2322 [Print] United States |
PMID | 11386613
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Ketone Bodies
- Lactates
- Pyruvates
- Vasodilator Agents
- dopexamine
- Glutamic Acid
- Glucose
- Alanine
- Oxygen
- Dopamine
- Norepinephrine
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Topics |
- Adult
- Aged
- Alanine
(metabolism)
- Blood Pressure
(physiology)
- Dopamine
(analogs & derivatives, pharmacology, therapeutic use)
- Female
- Glucose
(metabolism)
- Glutamic Acid
(metabolism)
- Hemodynamics
(drug effects, physiology)
- Humans
- Ketone Bodies
(metabolism)
- Lactates
(metabolism)
- Liver
(blood supply, drug effects, metabolism)
- Male
- Middle Aged
- Norepinephrine
(therapeutic use)
- Oxygen
(blood)
- Oxygen Consumption
(drug effects)
- Pyruvates
(metabolism)
- Regional Blood Flow
(drug effects)
- Shock, Septic
(drug therapy, metabolism, physiopathology)
- Splanchnic Circulation
(drug effects)
- Vasodilator Agents
(pharmacology, therapeutic use)
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