AJP - Heart Fuel your research with LabChart
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
 QUICK SEARCH:   [advanced]


     


Am J Physiol Heart Circ Physiol (August 19, 2004). doi:10.1152/ajpheart.00450.2004
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
287/6/H2545    most recent
00450.2004v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Minneci, P. C
Right arrow Articles by Solomon, S. B
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Minneci, P. C
Right arrow Articles by Solomon, S. B
Submitted on May 14, 2004
Accepted on August 16, 2004

Differing Effects of Epinephrine, Norepinephrine, and Vasopressin on Survival in a Canine Model of Septic Shock

Peter C Minneci*, Katherine J Deans1, Steven M Banks1, Renee Costello1, Gyorgy Csako1, Peter Q Eichacker1, Robert L Danner1, Charles Natanson1, and Steven B Solomon1

1 Critical Care Medicine Department, National Institutes of Health, Bethesda, MD, USA

* To whom correspondence should be addressed. E-mail: pminneci{at}mail.cc.nih.gov.

During sepsis, limited data on the survival effects of vasopressors are available to guide therapy; therefore we compared the effects of three vasopressors on survival in a canine septic shock model. Seventy-eight awake dogs infected with differing doses of intraperitoneal E. coli to produce increasing mortality were randomized to receive epinephrine (0.2, 0.8 or 2.0 mcg/kg/min), norepinephrine (0.2, 1.0, or 2.0 mcg/kg/min), vasopressin (0.01 or 0.04 U/min) or placebo in addition to antibiotics and fluids. Serial hemodynamic and biochemical variables were measured. Increasing doses of bacteria caused progressively greater decreases in survival (p<0.06), mean arterial pressure (MAP) (p<0.05), cardiac index (CI) (p<0.02), and ejection fraction (EF) (p=0.02). The effects of epinephrine on survival were significantly different than norepinephrine and vasopressin (p=0.03). Epinephrine had a harmful effect on survival that was significantly related to drug dose (p=0.02) but not bacterial dose. Norepinephrine and vasopressin had beneficial effects on survival that were similar at all drug and bacteria doses. Compared to concurrent infected controls, epinephrine caused greater decreases in CI, EF, and pH, and greater increases in systemic vascular resistance and serum creatinine than norepinephrine and vasopressin. These epinephrine-induced changes were significantly related to the dose of epinephrine administered. In this study, the effects of vasopressors were independent of severity of infection, but dependent on the type and dose of vasopressor used. Epinephrine adversely affected organ function, systemic perfusion and survival compared to norepinephrine and vasopressin. In the ranges studied, norepinephrine and vasopressin have more favorable risk-benefit profiles than epinephrine during sepsis.




This article has been cited by other articles:


Home page
Canadian J. AnesthesiaHome page
P. Farand, M. Hamel, F. Lauzier, G. E. Plante, and O. Lesur
Review article: Organ perfusion/permeability-related effects of norepinephrine and vasopressin in sepsis: [Expose de synthese : Les effets relies a la perfusion et a la permeabilite organique de la norepinephrine et de la vasopressine durant le "sepsis"].
Can J Anesth, September 1, 2006; 53(9): 934 - 946.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Visit Other APS Journals Online
Copyright © 1977 by the American Physiological Society.