Effects of adenosine on cardiopulmonary functions and oxygen-derived variables during endotoxemia

Abstract

Infusion of adenosine might be useful to improve flow-dependent oxygen delivery and tissue oxygenation during endotoxic shock without the induction of adverse cardiopulmonary side effects. The beneficial hemodynamic effects of adenosine appear not to be mediated by the inhibition of the release of tumor necrosis factor-alpha.

Changes in p i CO 2 reflect splanchnic mucosal ischaemia more reliably than changes in pH i during haemorrhagic shock

“…Although this difference is very small, it might influence the interpretation of data in the literature. This assumption is confirmed by a study presented by Thiel et al [30]. In a pig model of septic shock with less distinct changes of tonometric values, pH i became significant earlier than did p i CO 2 .…”

“…haemorrhagic shock) [20] or through dramatically increased local oxygen requirement (e.g. sepsis) [8,30,33]. Anaesthesia and surgery are known to adversely affect splanchnic perfusion [16], but the lack of suitable methods to monitor regional splanchnic perfusion, which are applicable in clinical practice for a long observation time, has prevented detection and impeded comprehension of these changes.…”

Adenosine A1 and A2 receptor agonists reduce endotoxin-induced cellular energy depletion and oedema formation in the lung

“…Even though data exist regarding the beneficial effects of adenosine on neutrophil activation [6][7][8][9], reversal of pulmonary hypertension [2] and oedema formation [3,4] in the context of acute lung injury, the impact of adenosine and its receptor sub-type-specific agonists is still virtually unexplored. In particular, tissue depletion of energy-rich adenine nucleotides in endotoxaemia as demonstrated by Sayeed [1], who observed significant reductions of ATP (238%), ADP (224%) and AMP (234%), deserves explanation.…”

“…Correspondingly, haemodynamic [2] and pulmonary conditions [3] improved in endotoxaemic pigs when adenosine was administered. Moreover, pretreatment with adenosine reversed neutrophilinduced pulmonary oedema in isolated dog lungs [4].…”

Transcriptomic effects of adenosine 2A receptor deletion in healthy and endotoxemic murine myocardium

“…While adenosine analogues and A 2A R agonists can limit endotoxemic or septic injury in lung [15,16], liver [17], brain [18] and heart [19][20][21], the roles of intrinsic A 2A R activity are less clear. Receptor deletion fails to modify inflammatory markers/injury in some studies [22], reportedly worsens endotoxemic injury in heart [23] and lung [15,24] and improves survival in models of polymicrobial sepsis [25,26].…”