Effects of sodium nitroprusside on splanchnic microcirculation in a resuscitated porcine model of septic shock.

Abstract

BACKGROUND:

We tested the hypothesis that sodium nitroprusside (SNP) might improve the impairment of hepatosplanchnic microcirculatory blood flow (MBF) in septic shock.

METHODS:

Fourteen pigs were anaesthetized and their lungs mechanically ventilated. Sepsis was induced with i.v. infusion of live Pseudomonas aeruginosa [1x10(8) colony forming units (CFU) ml(-1) kg(-1)] for 1 h. Sixty minutes later, the animals received in a random succession either SNP or normal saline for 30 min. Mean arterial pressure (MAP), cardiac index (CI), mean pulmonary artery pressure (MPAP), carbon dioxide tension of the ileal mucosa (PCO2; by gas tonometry), ileal mucosal and hepatic MBF by laser Doppler flowmetry, blood gases, and lactates were assessed before, during administration, and 30 min after discontinuing the test drug.

RESULTS:

Bacterial infusion promoted hypodynamic shock (MAP -18%, CI -33%, ileal MBF -19%, and hepatic MBF -27%), which was converted to normodynamic shock by resuscitation. During SNP infusion, ileal mucosal MBF significantly increased (+19%) compared with control (P = 0.033). Although hepatic MBF increased (+42% from baseline), this did not differ from control. In order to maintain a constant central venous pressure and MAP, fluid loading and norepinephrine (P < 0.01) were increased. Acid-base status was not altered by SNP.

CONCLUSIONS:

In a resuscitated porcine model of the early phase of septic shock, SNP improved ileal mucosal MBF but required a concomitant increase in fluid and norepinephrine supplements to maintain constant systemic haemodynamic parameters.

• Authors: A Assadi, O Desebbe, C Kaminski, T Rimmelé, F Bénatir, J Goudable, D Chassard, B Allaouchiche
• Journal: British journal of anaesthesia (Br J Anaesth) Vol. 100 Issue 1 Pg. 55-65 (Jan 2008) ISSN: 1471-6771 [Electronic] England
• PMID: 17982168 (Publication Type: Journal Article)

Chemical References

• Vasodilator Agents
• Nitroprusside

Topics

• Acid-Base Equilibrium (drug effects)
• Animals
• Disease Models, Animal
• Drug Evaluation, Preclinical (methods)
• Female
• Ileum (blood supply)
• Intestinal Mucosa (blood supply)
• Liver Circulation (drug effects)
• Microcirculation (drug effects)
• Nitroprusside (pharmacology)
• Regional Blood Flow (drug effects)
• Respiration, Artificial
• Shock, Septic (physiopathology, therapy)
• Splanchnic Circulation (drug effects)
• Sus scrofa
• Vasodilator Agents (pharmacology)