Temporary elimination of orthostatic hypotension by norepinephrine infusion.

Abstract

A cardinal manifestation of chronic autonomic failure is neurogenic orthostatic hypotension (OH), which often is associated with supine hypertension, posing a therapeutic dilemma. We report here success in a first step toward development of a "prosthetic baroreceptor system" to maintain blood pressure during orthostasis without worsening supine hypertension. In all of four patients with neurogenic OH, titrated i.v. NE infusion kept directly recorded intra-arterial pressure at or above baseline during progressive head-up tilt. We conclude that titrated i.v. NE infusion temporarily eliminates OH.

• Authors: David S Goldstein, LaToya Sewell, Courtney Holmes, Sandra Pechnik, André Diedrich, David Robertson
• Journal: Clinical autonomic research : official journal of the Clinical Autonomic Research Society (Clin Auton Res) Vol. 22 Issue 6 Pg. 303-6 (Dec 2012) ISSN: 1619-1560 [Electronic] Germany
• PMID: 22983778 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, N.I.H., Intramural)

Chemical References

• Vasoconstrictor Agents
• Norepinephrine

Topics

• Blood Pressure (drug effects)
• Humans
• Hypotension, Orthostatic (drug therapy, etiology)
• Infusions, Intra-Arterial
• Norepinephrine (therapeutic use)
• Parkinson Disease (complications, drug therapy)
• Pure Autonomic Failure (complications, drug therapy)
• Tilt-Table Test
• Treatment Outcome
• Vasoconstrictor Agents (therapeutic use)