Effects of nitric oxide synthase inhibition on the cardiovascular response to low output shock

Lorente, José A.; Landín, Luis; Canas, Paloma; Delgado, Miguel; Albaya, Antonio; Renes, Emilio; Jorge, Pablo; Liste, D.

doi:10.1097/00003246-199603000-00019

“…The data on afterload increase in CS are consistent with two other observations: First, patients with the so called non-hypotensive form of CS have better survival rates [29]. Second, in an experimental model of CS by pericardial tamponade, the animals treated by LNNA (N omega-nitro-L-arginine) had significantly less lactate increase during the observation period of 180 minutes than the sham and corticosteroids control groups [30].…”

Section: Cs -An Inflammatory Disease!supporting

confidence: 85%

Cardiogenic shock – an inflammatory disease

Gisslinger

¹

2006

Wien Klin Wochenschr

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“…This increase in oxygen extraction may be related to a redistribution of blood flow to metabolically active tissue, away from metabolically less active tissue [11,22].…”

Section: Discussionmentioning

confidence: 99%

Noradrenaline and Nω-monomethyl-L-arginine (L-NMMA): effects on haemodynamics and regional blood flow in healthy and septic sheep

BOOKE¹,

HINDER²,

MCGUIRE³

et al. 2000

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This prospective, non-randomized, controlled experimental study looks at the effects of N(omega)-monomethyl-L-arginine (L-NMMA) on haemodynamics, oxygen transport and regional blood flow in healthy and septic sheep, and compares these effects with those of noradrenaline (NA; norepinephrine). All sheep were chronically instrumented. Six sheep received L-NMMA (7 mg.kg(-1).h(-1)), six sheep received NA, and seven sheep received the carrier alone (0.9% NaCl). The NA dosage was continuously and individually adjusted to achieve the same increase in blood pressure as observed in matched sheep of the L-NMMA group (non-septic phase). Treatment was discontinued after 3 h. Sepsis was initiated and maintained by a continuous infusion of live Pseudomonas aeruginosa. After 24 h of sepsis, the sheep were again challenged over a treatment period of 3 h with their previously assigned drug (septic phase). During the non-septic phase of the experiment, NA and L-NMMA both caused an increase in mean arterial pressure (MAP) through vasoconstriction. Ater 24 h of sepsis, all sheep developed a hyperdynamic circulatory state. While L-NMMA caused an increase in MAP through intense vasoconstriction, NA caused MAP to increase through a further elevation of the cardiac index. The NA dosage needed was significantly higher in the septic phase compared with the non-septic phase, reflecting a reduced vascular responsiveness to catecholamines during sepsis. Renal blood flow remained unchanged during either treatment in both the non-septic and the septic phases. Nevertheless, urine output increased during NA treatment in both the non-septic and the septic phases, while L-NMMA caused urine output to increase only under septic conditions.

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“…This increase in oxygen extraction may be related to a redistribution of blood flow to metabolically active tissue, away from metabolically less active tissue [11,22]. This increase in oxygen extraction may be related to a redistribution of blood flow to metabolically active tissue, away from metabolically less active tissue [11,22].…”

Section: Discussionmentioning

confidence: 99%

Noradrenaline and Nω-monomethyl-L-arginine (L-NMMA): effects on haemodynamics and regional blood flow in healthy and septic sheep

Booke

¹

,

Hinder

²

,

McGuire

³

et al. 2000

View full text Add to dashboard Cite

This prospective, non-randomized, controlled experimental study looks at the effects of N(omega)-monomethyl-L-arginine (L-NMMA) on haemodynamics, oxygen transport and regional blood flow in healthy and septic sheep, and compares these effects with those of noradrenaline (NA; norepinephrine). All sheep were chronically instrumented. Six sheep received L-NMMA (7 mg.kg(-1).h(-1)), six sheep received NA, and seven sheep received the carrier alone (0.9% NaCl). The NA dosage was continuously and individually adjusted to achieve the same increase in blood pressure as observed in matched sheep of the L-NMMA group (non-septic phase). Treatment was discontinued after 3 h. Sepsis was initiated and maintained by a continuous infusion of live Pseudomonas aeruginosa. After 24 h of sepsis, the sheep were again challenged over a treatment period of 3 h with their previously assigned drug (septic phase). During the non-septic phase of the experiment, NA and L-NMMA both caused an increase in mean arterial pressure (MAP) through vasoconstriction. Ater 24 h of sepsis, all sheep developed a hyperdynamic circulatory state. While L-NMMA caused an increase in MAP through intense vasoconstriction, NA caused MAP to increase through a further elevation of the cardiac index. The NA dosage needed was significantly higher in the septic phase compared with the non-septic phase, reflecting a reduced vascular responsiveness to catecholamines during sepsis. Renal blood flow remained unchanged during either treatment in both the non-septic and the septic phases. Nevertheless, urine output increased during NA treatment in both the non-septic and the septic phases, while L-NMMA caused urine output to increase only under septic conditions.

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Effects of nitric oxide synthase inhibition on the cardiovascular response to low output shock

Cited by 12 publications

References 27 publications

Cardiogenic shock – an inflammatory disease

Cardiogenic shock – an inflammatory disease

Noradrenaline and Nω-monomethyl-L-arginine (L-NMMA): effects on haemodynamics and regional blood flow in healthy and septic sheep

Noradrenaline and Nω-monomethyl-L-arginine (L-NMMA): effects on haemodynamics and regional blood flow in healthy and septic sheep

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