Document Detail

Effect of PGE1 on altered distribution of regional blood flows in hyperdynamic sepsis.
MedLine Citation:
PMID:  1959417     Owner:  NLM     Status:  MEDLINE    
Since the sepsis syndrome is associated with depressed vascular reactivity, it may be incorrect to assume that pharmacologically mediated changes in cardiac output will be proportionately distributed at the regional level of the circulation. We examined the effect of hyperdynamic sepsis and the concurrent administration of the vasodilatory prostaglandin (PGE1) on the regional distribution of blood flows (Q) in unanesthetized sheep rendered septic by cecal ligation and perforation. Systemic Q progressively increased throughout a 48-h study period after cecal ligation and perforation. Simultaneously, organ Q, measured by the radioactive microsphere technique, was depressed to the pancreas, but increased to the heart, gallbladder, brain, and colon; the increased Q to both heart and gallbladder was greater than the simultaneous increase in systemic Q in this septic study. With the infusion of PGE1 (1 microgram/kg/min), mean arterial perfusing pressures fell, while the cardiac index increased further over that recorded during the 48-h septic study. Despite this depression in arterial pressures, the only significant effect of PGE1 on the interorgan distribution of Q was in the renal circulation, where it was demonstrated that kidney Q fell. We conclude that (1) hyperdynamic and normotensive sepsis exerted nonhomogeneous effects on the distribution of organ Q, and (2) an increased systemic Q during PGE1 infusion was proportionately distributed to all organs, except the kidneys, where Q paradoxically fell. The latter finding suggests that the regulation of kidney Q may be depressed across the normal range of arterial perfusing pressures in the sepsis syndrome. Further investigation is essential to understand the effect of clinical interventions on the control of tissue O2 flux at both the regional and microregional levels of the circulation.
R F Raper; W J Sibbald; J Hobson; F S Rutledge
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  100     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-08     Completed Date:  1992-01-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1703-11     Citation Subset:  AIM; IM    
Richard Ivey Critical Care Trauma Centre, Victoria Hospital, London, Ontario, Canada.
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MeSH Terms
Alprostadil / pharmacology*
Blood Circulation / drug effects*
Blood Pressure / drug effects
Carbon Dioxide / blood
Hemodynamics / drug effects
Infection / metabolism,  physiopathology*
Oxygen / blood
Oxygen Consumption / drug effects
Regional Blood Flow / drug effects
Reg. No./Substance:
124-38-9/Carbon Dioxide; 745-65-3/Alprostadil; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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