Recurrent episodes of Gram-negative bacteremia or endotoxemia change reactivity of pre- and post-capillary pulmonary segments to Angiotensin or free radicals

Kirton, Orlando C.; Gore, Ronald; Reid, Lynne; Jones, Rosemary

doi:10.1007/bf01706478

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…Endotoxin is more likely to cause the spasm of small blood vessels, thereby causing microcirculation disorders. 29 The smaller urine output of patients with abdominal sepsis also indicated a poorer prognosis, which can be mutually confirmed by their higher ICU mortality rate.…”

Section: Discussionmentioning

confidence: 90%

Origin of Sepsis Associated with the Short-Term Mortality of Patients: A Retrospective Study Using the eICU Collaborative Research Database

Li¹,

Tong²,

Wang³

et al. 2021

IJGM

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Objective The aim of this study was to compare the clinical characteristics and short-term mortality of patients with abdominal and pulmonary sepsis. Design Retrospective cohort study. Setting Adult intensive care units (ICUs) at tertiary hospitals. Participants Adult ICU patients from 2014 to 2015 in the eICU Collaborative Research Database. Interventions In univariate analysis, we compared the differences in the characteristics of patients in each group. Logistic regression models were used to evaluate the relationships between primary site of sepsis and short-term prognosis. Primary and Secondary Outcome Measures Hospital and ICU survival. Results The final dataset included 7023 pulmonary and 2360 abdominal sepsis patients, who accounted for 74.84% and 25.16%, respectively. We compared the results of the baseline characteristics, vital signs and laboratory indicators between the two groups. In the logistic regression models, we found that the hospital and ICU mortality of patients with abdominal sepsis was higher than that with pulmonary sepsis (p < 0.05, OR = 1.15, p < 0.05, OR = 1.19, respectively), although these results were no longer significantly after adjustment for confounders, but in the subgroups with SOFA score ≧ 8, the adjusted hospital mortality rate of patients with abdominal sepsis was 1.30 times higher than that of patients with pulmonary sepsis (p < 0.005, OR = 1.30, 95% CI 1.09–1.55), while there was no significant difference in the subgroups that SOFA score < 8. Conclusion In the patients with SOFA score ≧ 8, the adjusted hospital mortality of patients with abdominal sepsis was higher than patients with pulmonary sepsis.

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Section: Discussionmentioning

confidence: 90%

Origin of Sepsis Associated with the Short-Term Mortality of Patients: A Retrospective Study Using the eICU Collaborative Research Database

Li¹,

Tong²,

Wang³

et al. 2021

IJGM

View full text Add to dashboard Cite

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“…To examine the effects of PDE5 inhibition in the absence and presence of inhaled NO in ALI, we studied pulmonary vasodilatory response patterns of zaprinast and sildenafil and their ability to improve responsiveness to inhaled NO isolated-perfused lungs from rats pre-treated with endotoxin. Prior studies have demonstrated that although rats are relatively resistant to endotoxin, administration of LPS produces interstitial and alveolar edema, thickening of lung microvascular walls, and leukocyte adherence and infiltration [21,22]. Although zaprinast and sildenafil showed different patterns of pulmonary vasodilation both augmented the response to inhaled NO.…”

Section: Figmentioning

confidence: 99%

Low-Dose Phosphodiesterase Inhibition Improves Responsiveness to Inhaled Nitric Oxide in Isolated Lungs From Endotoxemic Rats

Klein

Zils

Bopp

et al. 2007

Journal of Surgical Research

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“…In rabbit cardiac myocytes, angiotensin II and endotoxin have synergistic effects on the activation of nitric oxide and cyclic GMP pathways to induce dose-dependent impairment of contractile functions (42). In mice and rats, endotoxin also alters the vascular reactivity to angiotensin II (13,22), and the blood pressure response to exogenous angiotensin II is significantly diminished (4). It has been shown that angiotensin II type 1 receptor expression is markedly downregulated in septic rats, an effect that could be reproduced in vitro by administration of nitric oxide as well as by a combination of proinflammatory cytokines to rat renal mesangial cells (4).…”

Section: G253 Blood Flow Regulation: Dobutamine and Endotoxinmentioning

confidence: 99%

Effects of cardiac preload reduction and dobutamine on hepatosplanchnic blood flow regulation in porcine endotoxemia

Jakob¹,

Bracht²,

Porta³

et al. 2012

American Journal of Physiology-Gastrointestinal and Liver Physi

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Takala J. Effects of cardiac preload reduction and dobutamine on hepatosplanchnic blood flow regulation in porcine endotoxemia. Am J Physiol Gastrointest Liver Physiol 303: G247-G255, 2012. First published May 3, 2012 doi:10.1152/ajpgi.00433.2011.-Insufficient cardiac preload and impaired contractility are frequent in early sepsis. We explored the effects of acute cardiac preload reduction and dobutamine on hepatic arterial (Qha) and portal venous (Qpv) blood flows during endotoxin infusion. We hypothesized that the hepatic arterial buffer response (HABR) is absent during preload reduction and reduced by dobutamine. In anesthetized pigs, endotoxin or vehicle (n ϭ 12, each) was randomly infused for 18 h. HABR was tested sequentially by constricting superior mesenteric artery (SMA) or inferior vena cava (IVC). Afterward, dobutamine at 2.5, 5.0, and 10.0 g/kg per minute or another vehicle (n ϭ 6, each) was randomly administered in endotoxemic and control animals, and SMA was constricted during each dose. Systemic (cardiac output, thermodilution) and carotid, splanchnic, and renal blood flows (ultrasound Doppler) and blood pressures were measured before and during administration of each dobutamine dose. HABR was expressed as hepatic arterial pressure/ flow ratio. Compared with controls, 18 h of endotoxin infusion was associated with decreased mean arterial blood pressure [49 Ϯ 11 mmHg vs. 58 Ϯ 8 mmHg (mean Ϯ SD); P ϭ 0.034], decreased renal blood flow, metabolic acidosis, and impaired HABR during SMA constriction [0.32 (0.18 -1.32) mmHg/ml vs. 0.22 (0.08 -0.60) mmHg/ml; P ϭ 0.043]. IVC constriction resulted in decreased Qpv in both groups; whereas Qha remained unchanged in controls, it decreased after 18 h of endotoxemia (P ϭ 0.031; constriction-timegroup interaction). One control and four endotoxemic animals died during the subsequent 6 h. The maximal increase of cardiac output during dobutamine infusion was 47% (22-134%) in controls vs. 53% (37-85%) in endotoxemic animals. The maximal Qpv increase was significant only in controls [24% (12-47%) of baseline (P ϭ 0.043) vs. 17% (Ϫ7-32%) in endotoxemia (P ϭ 0.109)]. Dobutamine influenced neither Qha nor HABR. Our data suggest that acute cardiac preload reduction is associated with preferential hepatic arterial perfusion initially but not after established endotoxemia. Dobutamine had no effect on the HABR. hepatic arterial buffer response; sepsis; liver INADEQUATE SPLANCHNIC PERFUSION is associated with multiple organ failure and death (11, 23), especially when hepatic dysfunction is present (28). Global hepatic blood flow is supposed to be relatively protected when gut blood flow decreases because hepatic arterial flow increases when portal venous flow decreases (the hepatic arterial buffer response, HABR) (25, 26). However, evidence suggests that the HABR is diminished or even abolished during endotoxemia (1) and when gut blood flow becomes very low (19,31).The HABR is usually assessed by decreasing superior mesenteric or portal venous blood flow and measurement of ...

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Recurrent episodes of Gram-negative bacteremia or endotoxemia change reactivity of pre- and post-capillary pulmonary segments to Angiotensin or free radicals

Abstract: Abnormal lung vascular reactivity after SEPSIS or ENDOTOXIN is evident on challenge, the two agents used here detecting site specific changes.

Cited by 4 publications

References 22 publications

Origin of Sepsis Associated with the Short-Term Mortality of Patients: A Retrospective Study Using the eICU Collaborative Research Database

Origin of Sepsis Associated with the Short-Term Mortality of Patients: A Retrospective Study Using the eICU Collaborative Research Database

Low-Dose Phosphodiesterase Inhibition Improves Responsiveness to Inhaled Nitric Oxide in Isolated Lungs From Endotoxemic Rats

Effects of cardiac preload reduction and dobutamine on hepatosplanchnic blood flow regulation in porcine endotoxemia

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