Document Detail


Cardiopulmonary effects of low-dose arginine vasopressin in ovine acute lung injury.
MedLine Citation:
PMID:  21057315     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : To elucidate the effects of low-dose arginine vasopressin on cardiopulmonary functions and nitrosative stress using an established model of acute lung injury.
DESIGN: : Prospective, randomized, controlled laboratory experiment.
SETTING: : Investigational intensive care unit.
SUBJECTS: : Eighteen chronically instrumented sheep.
INTERVENTIONS: : Sheep were randomly assigned to a sham group without injury or treatment, an injury group without treatment (40% total body surface area third-degree burn and 48 breaths of cold cotton smoke), or an injured group treated with arginine vasopressin (0.02 IU·min) from 1 hr after injury until the end of the 24-hr study period (each n = 6). All sheep were mechanically ventilated and fluid resuscitated using an established protocol.
MEASUREMENTS AND MAIN RESULTS: : There were no differences among groups at baseline. The injury was characterized by a severe deterioration of cardiopulmonary function (left ventricular stroke work indexes and Pao2/Fio2 ratio; p < .01 each vs. sham). Compared with controls, arginine vasopressin infusion improved myocardial function, as suggested by higher stroke volume indexes and left ventricular stroke work indexes (18-24 hrs and 6-24 hrs, respectively; p < .05 each). In addition to an improved gas exchange (higher Pao2/Fio2 ratios from 6 to 24 hrs, p < .01 each), pulmonary edema (bloodless wet-to-dry-weight ratio; p = .018), bronchial obstruction (p = .01), and pulmonary shunt fraction (12-24 hrs; p ≤ .001 each) were attenuated in arginine vasopressin-treated animals compared with controls. These changes occurred along with reduced nitrosative stress, as indicated by lower plasma levels of nitrate/nitrite (12-24 hrs, p < .01 each), as well as lower myocardial and pulmonary tissue concentrations of 3-nitrotyrosine (p = .041 and p = .042 vs. controls, respectively). At 24 hrs, pulmonary 3-nitrotyrosine concentrations were negatively correlated with Pao2/Fio2 ratio (r = -.882; p < .001) and myocardial 3-nitrotyrosine content with stroke volume indexes (r = -.701; p = .004).
CONCLUSIONS: : Low-dose arginine vasopressin reduced nitrosative stress and improved cardiopulmonary functions in sheep with acute lung injury secondary to combined burn and smoke inhalation injury.
Authors:
Martin Westphal; Sebastian Rehberg; Marc O Maybauer; Dirk M Maybauer; Perenlei Enkhbaatar; Beena B Westphal-Varghese; Frank C Schmalstieg; Naoki Morita; Robert A Cox; Lillian D Traber; Hal Hawkins; Elbert Whorton; Daniel L Traber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  39     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-63     Citation Subset:  AIM; IM    
Affiliation:
From the Departments of Anesthesiology (MW, SR, MOM, DMM, PE, BBW-V, NM, LDT, DLT), Pediatrics (FCS), Pathology (RAC, HH), and Biostatistics and Epidemiology (EW), The University of Texas Medical Branch, Galveston, TX; and the Department of Anesthesiology and Intensive Care (MW, SR), University of Muenster, Muenster, Germany.
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