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This Article Full Text Full Text (PDF) All Versions of this Article: 289/1/H168    most recent 01235.2004v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Knotzer, H. Articles by Hasibeder, W. R. Search for Related Content PubMed PubMed Citation Articles by Knotzer, H. Articles by Hasibeder, W. R.

Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension

Departments of ¹Anesthesiology and Critical Care Medicine, ²General Surgery, and ³Biostatistics and Documentation, Innsbruck Medical University, Innsbruck; and ⁴Department of Anesthesiology and Critical Care Medicine, Krankenhaus der Barmherzigen Schwestern Ried, Ried, Austria

Submitted 7 December 2004 ; accepted in final form 9 March 2005

We investigated intestinal oxygen supply and mucosal tissue PO₂ during administration of increasing dosages of continuously infused arginine vasopressin (AVP) in an autoperfused, innervated jejunal segments in anesthetized pigs. Mucosal tissue PO₂ was measured by employing two Clark-type surface oxygen electrodes. Oxygen saturation of jejunal microvascular hemoglobin was determined by tissue reflectance spectrophotometry. Microvascular blood flow was assessed by laser-Doppler velocimetry. Systemic hemodynamic variables, mesenteric venous and systemic acid-base and blood gas variables, and lactate measurements were recorded. Measurements were performed at baseline and at 20-min intervals during incremental AVP infusion (n = 8; 0.007, 0.014, 0.029, 0.057, 0.114, and 0.229 IU·kg^–1·h^–1, respectively) or infusion of saline (n = 8). AVP infusion led to a significant (P < .05), dose-dependent decrease in cardiac index (from 121 ± 31 to 77 ± 27 ml·kg^–1·min^–1 at 0.229 IU·kg^–1·h^–1) and systemic oxygen delivery (from 14 ± 3 to 9 ± 3 ml·kg^–1·min^–1 at 0.229 IU·kg^–1·h^–1) concomitant with an increase in systemic oxygen extraction ratio (from 31 ± 4 to 48 ± 10%). AVP decreased microvascular blood flow (from 133 ± 47 to 82 ± 35 perfusion units at 0.114 IU·kg^–1·h^–1), mucosal tissue PO₂ (from 26 ± 7 to 7 ± 2 mmHg at 0.229 IU·kg^–1·h^–1), and microvascular hemoglobin oxygen saturation (from 51 ± 9 to 26 ± 12% at 0.229 IU·kg^–1·h^–1) without a significant increase in mesenteric venous lactate concentration (2.3 ± 0.8 vs. 3.4 ± 0.7 mmol/l). We conclude that continuously infused AVP decreases intestinal oxygen supply and mucosal tissue PO₂ due to a reduction in microvascular blood flow and due to the special vascular supply in the jejunal mucosa in a dose-dependent manner in pigs.

mucosal oxygen delivery; microcirculatory blood flow; Clark-type surface oxygen electrodes; reflectance spectrophotometry; jejunum