Document Detail


Epinephrine Induces Rapid Deterioration in Pulmonary Oxygen Exchange in Intact, Anesthetized Rats: A Flow and Pulmonary Capillary Pressure-dependent Phenomenon.
MedLine Citation:
PMID:  22902967     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Previous studies indicate epinephrine adversely affects arterial oxygenation when administered in a rat model of local anesthetic overdose. The authors tested whether epinephrine alone exerts similar effects in the intact animal. METHODS:: Anesthetized rats received a single intravenous injection of epinephrine (25, 50, or 100 mcg/kg); matched cohorts were pretreated with phentolamine (100 mcg/kg); n = 5 for each of the six treatment groups. Arterial pressure and blood gases were measured at baseline, 1 and 10 min after epinephrine administration. Pulmonary capillary pressures during epinephrine infusion with normal and increased flows were measured in an isolated lung preparation. RESULTS:: Epinephrine injection in the intact animal caused hypoxemia, hypercapnia, and acidosis at all doses. Arterial oxygen tension was reduced within 1 min of injection. Hyperlactatemia occurred by 10 min after 50 and 100 mcg/kg. Rate pressure product was decreased by 10 min after 100 mcg/kg epinephrine. Pretreatment with phentolamine attenuated these effects except at 100 mcg/kg epinephrine. In the isolated lung preparation, epinephrine in combination with increased pulmonary flow increased pulmonary capillary pressure and lung water. CONCLUSIONS:: Bolus injection of epinephrine in the intact, anesthetized rat impairs pulmonary oxygen exchange within 1 min of treatment. Effects were blunted by α-adrenergic receptor blockade. Edema occurred in the isolated lung above a threshold pulmonary capillary pressure when epinephrine treatment was coupled with an increase in pulmonary flow. These results potentially argue against using traditional doses of epinephrine for resuscitation, particularly in the anesthetized patient.
Authors:
Vijay Krishnamoorthy; David B Hiller; Richard Ripper; Bocheng Lin; Stephen M Vogel; Douglas L Feinstein; Sarah Oswald; Leelach Rothschild; Priscilla Hensel; Israel Rubinstein; Richard Minshall; Guy L Weinberg
Related Documents :
22613077 - The effect of alveolar dead space on the measurement of end-expiratory lung volume by m...
22742867 - Factors associated with noninvasive coronary flow reserve in severe aortic stenosis.
22556397 - Does increased baseline ventilation heterogeneity following chest wall strapping predis...
7586427 - Effects of elevated coronary sinus pressure on coronary blood flow and left ventricular...
20409927 - Effectiveness of the selective aldosterone blocker, eplerenone, in patients with resist...
6354937 - Mood changes during captopril therapy for hypertension. a double-blind pilot study.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-17
Journal Detail:
Title:  Anesthesiology     Volume:  -     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
* Assistant Professor, Department of Anesthesiology, University of Illinois College of Medicine at Chicago, Chicago, Illinois. † Resident, Department of Anesthesiology, University of Illinois College of Medicine at Chicago. ‡ Senior Research Associate, Department of Anesthesiology, University of Illinois College of Medicine at Chicago. § Research Associate, Department of Anesthesiology, University of Illinois College of Medicine at Chicago. ∥ Research Associate Professor, Department of Pharmacology, University of Illinois College of Medicine at Chicago. # Research Professor, Department of Anesthesiology, University of Illinois College of Medicine at Chicago. ** Professor, Department of Medicine, University of Illinois College of Medicine at Chicago and the Jesse Brown VA Medical Center, Chicago, Illinois. †† Associate Professor, Department of Pharmacology, University of Illinois College of Medicine at Chicago. ‡‡ Professor, Department of Anesthesiology, University of Illinois College of Medicine at Chicago and Jesse Brown VA Medical Center.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Deficits in Retention for Verbally Presented Medical Information.
Next Document:  An appeal for the presentation of detailed human derived data for dose-response calculations in nutr...