Document Detail


Is persistent hypotension after transient cardiogenic shock associated with an inflammatory response?
MedLine Citation:
PMID:  18797696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the recovery of cardiovascular function after transient cardiogenic shock. Cardiac tamponade was performed for 1 h and post-shock data were collected in 5 domestic large white female pigs (43 +/- 5 kg) for 6 h. The control group (N = 5) was observed for 6 h after 1 h of resting. During 1 h of cardiac tamponade, experimental animals evolved a low perfusion status with a higher lactate level (8.0 +/- 2.2 vs 1.9 +/- 0.9 mEq/L), lower standard base excess (-7.3 +/- 3.3 vs 2.0 +/- 0.9 mEq/L), lower urinary output (0.9 +/- 0.9 vs 3.0 +/- 1.4 mL x kg(-1) x h(-1)), lower mixed venous saturation, higher ileum partial pressure of CO2-end tidal CO2 (EtCO2) gap and a lower cardiac index than the control group. Throughout the 6-h recovery phase after cardiac tamponade, tamponade animals developed significant tachycardia with preserved cardiac index, resulting in a lower left ventricular stroke work, suggesting possible myocardial dysfunction. Vascular dysfunction was present with persistent systemic hypotension as well as persistent pulmonary hypertension. In contrast, oliguria, hyperlactatemia and metabolic acidosis were corrected by the 6th hour. The inflammatory characteristics were an elevated core temperature and increased plasma levels of interleukin-6 in the tamponade group compared to the control group. We conclude that cardiovascular recovery after a transient and severe low flow systemic state was incomplete. Vascular dysfunction persisted up to 6 h after release of tamponade. These inflammatory characteristics may also indicate that inflammatory activation is a possible pathway involved in the pathogenesis of cardiogenic shock.
Authors:
M Park; A T Maciel; D T Noritomi; M K Brunialti; R Salomão; G P P Schettino; L C P Azevedo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Brazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas / Sociedade Brasileira de Biofísica ... [et al.]     Volume:  41     ISSN:  1414-431X     ISO Abbreviation:  Braz. J. Med. Biol. Res.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-09-17     Completed Date:  2009-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8112917     Medline TA:  Braz J Med Biol Res     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  648-56     Citation Subset:  IM    
Affiliation:
Laboratório de Pesquisa em Medicina Intensiva e Anestesiologia, Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brasil. mpark@uol.com.br <mpark@uol.com.br>
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiac Tamponade / blood,  physiopathology*
Female
Hypotension / etiology,  physiopathology*
Recovery of Function
Shock, Cardiogenic / blood,  physiopathology*
Swine
Systemic Inflammatory Response Syndrome / etiology,  physiopathology*
Time Factors

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


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