Skip to main content
SpringerLink
Log in
Book cover

Yearbook of Intensive Care and Emergency Medicine pp 333–341Cite as

β-Adrenergic Drugs to improve Gastrointestinal Mucosal Blood Flow in Sepsis

  • Conference paper

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1996))

Abstract

The failure of gut oxygen uptake (VO2) to rebound with fluid resuscitation in lipopolysaccharide (LPS)-treated animals is in sharp contrast to non-LPS models of gut ischemia, including studies of systemic hypoxic hypoxia or ischemic hypoxia in which gut VO2 return to baseline with fluid resuscitation. This suggests that the pathophysiology of shock associated with LPS treatment has features such as microvascular and inflammatory mediator response derangements that are not involved in non-LPS hypoxia and ischemia, and cause sustained disturbances in gut VO2. After LPS infusion, blood flow-controlling sites in the gut microcirculation appear to be inadequate to maintain mucosal perfusion and oxygenation, and unable to prevent the preferential onset of VO2 dependence on flow in the gut despite adequate fluid resuscitation.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bailey RW, Bulkley GB, Levy KI, et al (1982) Pathogenesis of non-occlusive mesenteric ischemia: Study in a porcine model induced by pericardial tamponade. Surg Forum 33: 194–197

    Google Scholar 

  2. Porter JM, Sussman MS, Bulkley GB (1989) Splanchnic vasospasm in circulatory shock in splanchnic ischemia and multiple organ failure. In: Marston A, Bulkley GB, Fiddian-Green RG, et al (eds) Splanchnic ischemia and multiple organ failure. E Arnold, London, pp 73–88

    Google Scholar 

  3. Bailey RW, Bulkley GB, Hamilton SR, et al (1987) Protection of the small intestine from non-occlusive mesenteric ischemic injury due to cardiogenic shock. Am J Surg 153: 108–116

    Article  PubMed  CAS  Google Scholar 

  4. McNeil JR, Stark RD, Greenway CV (1970) Intestinal vasoconstriction after hemorrhage: Roles of vasopressin and angiotensin. Am J Physiol 219: 1342–1347

    Google Scholar 

  5. Grum CM, Fiddian-Green RG, Pittenger GL, et al (1984) Adequacy of tissue oxygenation in intact dog intestine. J Appl Physiol 56: 1065–1069

    PubMed  CAS  Google Scholar 

  6. Schlichtig R, Bowles SA (1994) Distinguishing between aerobic and anaerobic appearance of dissolved CO2 in intestine during low flow. J Appl Physiol 76: 2443–2451

    PubMed  CAS  Google Scholar 

  7. Hartmann M, Montgomery A, Jonsson K, et al (1991) Tissue oxygenation in hemorrhagic shock measured as transcutaneous oxygen tension, subcutaneous oxygen tension, and gastrointestinal intramucosal pH in pigs. Crit Care Med 19: 205–210

    Article  PubMed  CAS  Google Scholar 

  8. Tang W, Weil MH, Sun S, et al (1994) Gastric intramural PCO2 as monitor of perfusion failure during hemorrhagic and anaphylactic shock. J Appl Physiol 76: 572–577

    PubMed  CAS  Google Scholar 

  9. Ohri SK, Becket J, Brannan J, et al (1994) Effects of cardiopulmonary bypass on gut blood flow, oxygen utilization, and intramucosal pH. Ann Thorac Surg 57: 1193–1199

    Article  PubMed  CAS  Google Scholar 

  10. Curtis SE, Cain SM (1992) Systemic and regional O2 delivery and uptake in bled dogs given hypertonic saline, whole blood, or dextran. Am J Physiol 262: 778–786

    Google Scholar 

  11. Dodd SL, King CE, Cain SM (1987) Responses of innervated and denervated gut to whole body hypoxia. J Appl Physiol 62: 651–657

    PubMed  CAS  Google Scholar 

  12. Carrol G, Synder J (1982) Hyperdynamic severe intravascular sepsis depends on fluid administration in cyonomolgus monkey. Am J Physiol 243:R131-RI41

    Google Scholar 

  13. Garrisson RN, Ratcliffe DJ, Fry DE (1980) Hepatocellular function and nutrient blood flow in experimental peritonitis. Surgery 92: 713–719

    Google Scholar 

  14. Whitworth PW, Cryer HM, Garrisson RN, et al (1989) Hypoperfusion of the intestinal microcirculation without decreased cardiac output during live Escherichia coli in rats. Circ Shock 27: 111–122

    PubMed  CAS  Google Scholar 

  15. Fink MP (1989) Systemic and splanchnic hemodynamic derangements in the sepsis syndrome. In: Marston A, Bulkley GB, Fiddian-Green RG, Haglund U (eds) Splanchnic ischemia and mulpiple organ failure. CV Mosby, St Louis, pp 101–106

    Google Scholar 

  16. Navaratman RL, Morris SE, Traber DL, et al (1990) Endotoxin (LPS) increases mesenteric vascular resistance (MVR) and bacterial translocation (BT). J Trauma 30: 1104–1113

    Article  Google Scholar 

  17. Theuer CJ, Wilson MA, Steeb GD, et al (1993) Microvascular vasoconstriction and mucosal hypoperfusion of the rat small intestine during bacteremia. Circ Shock 40: 61–68

    PubMed  CAS  Google Scholar 

  18. Nevière R, Chagnon LJ, Vallet B, et al (1995) Gut oxygenation in endotoxemic pigs during shock and resuscitation. Intensive Care Med 21: S18 (Abst)

    Article  Google Scholar 

  19. Payne JG, Bowen JC (1981) Hypoxia of canine gastric mucosa caused by E. coli sepsis and prevented with methylprednisolone therapy. Gastroenterology 80: 84–93

    PubMed  CAS  Google Scholar 

  20. Vallet B, Lund N, Curtis SE, et al (1994) Gut and muscle tissue PO2 in en do toxemic dogs during shock and resuscitation. J Appl Physiol 76: 793–800

    PubMed  CAS  Google Scholar 

  21. Shepherd AP (1980) Intestinal blood flow autoregulation during foodstuff absorption. Am J Physiol 239:HI56-HI62

    Google Scholar 

  22. Breslow Mj, Miller CF, Parker SD, et al (1987) Effect of vasopressors on organ blood flow during endotoxin shock in pigs. Am J Physiol 252:H291-H300

    PubMed  CAS  Google Scholar 

  23. Schneider AJ, Groeneveld AB, Teule GJ, et al (1991) Total body blood volume redistribution in porcine E. coli septic shock. Circ Shock 35: 215–222

    PubMed  CAS  Google Scholar 

  24. Bersten AD, Hersch M, Cheung H, et al (1992) The effect of various sympathomimetics on the regional circulations in hyperdynamic sepsis. Surgery 112: 549–561

    PubMed  CAS  Google Scholar 

  25. Falk A, Redfors S, Myrvold H, et al (1985) Small intestinal mucosal lesions in feline septic shock: A study on the pathogenesis. Circ Shock 17: 327–337

    PubMed  CAS  Google Scholar 

  26. Fink MP, Antonsson JB, Wang H, et al (1991) Increased intestinal permeability in endotoxic pigs. Arch Surg 126: 211–218

    PubMed  CAS  Google Scholar 

  27. Fink MP, Kaups KL, Wang H, et al (1991) Maintenance of superior mesenteric arterial perfusion prevents increased intestinal mucosal permeability in endotoxic pigs. Surgery 110: 154–161

    PubMed  CAS  Google Scholar 

  28. Shepherd AP, Riedel GL, Maxwell LC, et al (1984) Selective vasodilators redistribute intestinal blood flow and depress oxygen uptake. Am J Physiol 247: G377-G384

    PubMed  CAS  Google Scholar 

  29. Cain SM, Curtis SE (1992) Systemic and regional oxygen uptake and lactate flux in endotoxic dogs resuscitated with dextran and dopexamine or dextran alone. Circ Shock 38: 173–181

    PubMed  CAS  Google Scholar 

  30. Fiddian-Green RG (1995) Gastric intramucosal pH, tissue oxygenation and acid-base balance. Br J Anaesth 74: 591–606

    Article  PubMed  CAS  Google Scholar 

  31. Silverman HJ, Tuma P (1992) Gastric tonometry in patients with sepsis: Effects of dobutamine infusion and packed red blood cell transfusions. Chest 102: 184–188

    Article  PubMed  CAS  Google Scholar 

  32. Marik PE, Sibbald WJ (1993) The effect of stored blood transfusion on oxygen delivery in patients with sepsis. JAMA 269: 3024–3029

    Article  PubMed  CAS  Google Scholar 

  33. Smithies M, Yee TH, Jackson L, et al (1994) Protecting the gut and the liver in the critically ill: Effects of dopexamine. Crit Care Med 22: 789–795

    Article  PubMed  CAS  Google Scholar 

  34. Gutierrez G, Clark C, Brown SD, et al (1994) Effect of dobutamine on oxygen consumption and gastric mucosal pH in septic patients. Am J Respir Crit Care Med 150: 324–329

    PubMed  CAS  Google Scholar 

  35. Nevière R, Chagnon JL, Mathieu D, et al (1995) Effects of dobutamine and dopamine on gastric mucosal blood flow in septic patients. Am J Respir Crit Care Med 151: A446 (Abst)

    Google Scholar 

Download references

Authors
  1. R. Nevière
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Vallet
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Nevière, R., Vallet, B. (1996). β-Adrenergic Drugs to improve Gastrointestinal Mucosal Blood Flow in Sepsis. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 1996. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80053-5_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-80053-5_29

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-60552-2

  • Online ISBN: 978-3-642-80053-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation