Stomach, liver, kidney and skeletal muscle autoregulation evaluated by near-infrared spectroscopy in a swine model

Kurita, Tadayoshi; Kawashima, Shuichi; Khaleelullah, Mohamed Mathar Sahib Ibrahim; Nakajima, Yoshiyuki

doi:10.1007/s10877-022-00956-5

Cited by 2 publications

(5 citation statements)

References 28 publications

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“…In the liver, the TOI was pressure dependent over a wide MAP range, whereas, in the tongue, it was independent of blood pressure over a wide MAP range. These findings were consistent with those of our previous reports (11–13), indicating that the brain, tongue (muscle), and kidney are well autoregulated, whereas liver autoregulation is weak.…”

Section: Discussionsupporting

confidence: 93%

“…We recently investigated the autoregulation of the brain (11,12), spinal cord (12), stomach (13), liver (13), kidney (11,13), and quadriceps muscle (13) by inducing a wide range of blood pressures with phenylephrine and SNP in three circulating blood volume states: normal, hemorrhagic shock, and following fluid resuscitation, with NIRS probes directly on each organ, as in the present study, and examined the relationship between changes in the MAP and TOI in each organ. Although phenylephrine was used instead of norepinephrine as the vasopressor in these experiments, the relationship between the MAP and TOI of the brain, liver, and kidney was similar to that at baseline in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…We recently used pigs of the same size as the NIRS probes (NIRO-200; Hamamatsu Photonics, Hamamatsu, Japan) on the brain (11,12), spinal cord (12), stomach (13), liver (13), kidney (11,13), and quadriceps muscle (13) to investigate organ autoregulation under several different volume conditions. Near-infrared spectroscopy probes were attached to the brain, liver, and kidney using the surgical techniques and methods described in previous reports (11)(12)(13). First, the pigs were placed in the prone position.…”

Section: Attachment Of Nirs Probe To Each Organmentioning

confidence: 99%

“…After 30 min, vasopressin was infused at 0.6 U/min for 10 min and increased to 1.5, 3, and 6 U/min at 10-min intervals. The dosage of SNP under normal conditions was determined based on our previous reports (11)(12)(13), and those of norepinephrine and vasopressin were determined after confirming the effects of elevated blood pressure observed in the pilot studies. Because it was unclear how ventilation would affect tissue oxygenation in response to the progression of endotoxic shock, we did not change the inspiratory oxygen concentration or the ventilation volume of the ventilator even when endotoxic shock progressed.…”

Section: Experimental Protocolmentioning

confidence: 99%

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Impact of High-Dose Vasopressor During Endotoxic Shock on the Cerebral, Lingual, Hepatic, and Renal Microcirculation Evaluated by Near-Infrared Spectroscopy in Swine

Kurita,

Kawashima,

Khaleelullah

et al. 2023

Shock

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Background High-dose vasopressors maintain blood pressure during septic shock but may adversely reduce microcirculation in vital organs. We assessed the effect of high-dose norepinephrine and vasopressin on the microcirculation of the brain, tongue, liver, and kidney during endotoxic shock using near-infrared spectroscopy (NIRS). Methods Thirteen pigs (24.5 ± 1.8 kg) were anesthetized, and an NIRS probe was attached directly to each organ. Approximately 0.2, 0.5, 1, and 2 μg/kg/min of norepinephrine were administered in a stepwise manner, followed by 0.5, 1, 2, and 5 μg/kg/min of sodium nitroprusside in normal condition. Moreover, 1 μg/kg/h of lipopolysaccharide was administered continuously after 100 μg bolus to create endotoxic shock, and after 1000 mL of crystalloid infusion, high-dose norepinephrine (2, 5, 10, and 20 μg/kg/min) and vasopressin (0.6, 1.5, 3, and 6 U/min) were administered in a stepwise manner. The relationship between the mean arterial pressure (MAP) and each tissue oxygenation index (TOI) during vasopressor infusion was evaluated. Results Three pigs died after receiving lipopolysaccharides, and 10 were analyzed. An increase of >20% from the baseline MAP induced by high-dose norepinephrine during endotoxic shock reduced the TOI in all organs except the liver. The elevation of MAP to baseline with vasopressin alone increased the kidney and liver TOIs and decreased the tongue TOI. Conclusions Forced blood pressure elevation with high-dose norepinephrine during endotoxic shock decreased the microcirculation of vital organs, especially the kidney. Cerebral TOI may be useful for identifying the upper limit of blood pressure, at which norepinephrine impairs microcirculation.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Attachment Of Nirs Probe To Each Organmentioning

confidence: 99%

Section: Experimental Protocolmentioning

confidence: 99%

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Impact of High-Dose Vasopressor During Endotoxic Shock on the Cerebral, Lingual, Hepatic, and Renal Microcirculation Evaluated by Near-Infrared Spectroscopy in Swine

Kurita,

Kawashima,

Khaleelullah

et al. 2023

Shock

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“…This technique was initially applied clinically to monitor cerebral oxygenation in neonates; today it plays an important role in the diagnosis of hypoxic brain injury and the study of cerebral hemodynamics in preterm infants and neonates [ 8 , 9 ]. Other applications are largely experimental and relate to blood flow and perfusion studies in skeletal muscle and a variety of organs [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

rSO2 Measurement Using NIRS for Lower-Limb Blood Flow Monitoring and Estimation of Safe Balloon Occlusion/Deflation Time in Patients with PAS Who Underwent PBOA during CS

Tokue

Tsushima

2023

Medicina

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We examined the utility of regional oxygen saturation (rSO2) measurement using near-infrared spectroscopy (NIRS) for monitoring lower-limb blood flow and estimate the safe balloon occlusion/deflation time in patients with PAS who underwent prophylactic balloon occlusion of the abdominal artery (PBOA) during cesarean section (CS). During CS, the NIRS probes were positioned on either of the anterior tibial muscles. rSO2 was measured continuously during balloon occlusion/deflation. A cycle consisted of inflating the aortic balloon for 30 min and deflating it for 5 min. The rSO2 before/during balloon occlusion and after 5 min of balloon deflation were evaluated. Sixty-two lower limbs (fifteen women and data from 31 sessions of balloon inflation/deflation) were evaluated. rSO2 during balloon occlusion was significantly lower than rSO2 before balloon occlusion (57.9% ± 9.6% vs. 80.3% ± 6.0%; p < 0.01). There were no significant differences between rSO2 before balloon occlusion and rSO2 after 5 min of balloon deflation (80.3% ± 6.0% vs. 78.7% ± 6.6%; p = 0.07). Postoperatively, the lower limbs showed no ischemic symptoms. NIRS can assess lower-limb rSO2 during PBOA for PAS in real time to determine ischemia severity, duration, and recovery capacity.

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Stomach, liver, kidney and skeletal muscle autoregulation evaluated by near-infrared spectroscopy in a swine model

Cited by 2 publications

References 28 publications

Impact of High-Dose Vasopressor During Endotoxic Shock on the Cerebral, Lingual, Hepatic, and Renal Microcirculation Evaluated by Near-Infrared Spectroscopy in Swine

Impact of High-Dose Vasopressor During Endotoxic Shock on the Cerebral, Lingual, Hepatic, and Renal Microcirculation Evaluated by Near-Infrared Spectroscopy in Swine

rSO2 Measurement Using NIRS for Lower-Limb Blood Flow Monitoring and Estimation of Safe Balloon Occlusion/Deflation Time in Patients with PAS Who Underwent PBOA during CS

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