Beneficial Effects of Norepinephrine Alone on Cardiovascular Function and Tissue Oxygenation in a Pig Model of Cardiogenic Shock.

Abstract

INTRODUCTION:

The present study was developed to investigate the effects of norepinephrine alone on hemodynamics and intrinsic cardiac function in a pig model of cardiogenic shock mimicking the clinical setting.

METHODS:

Cardiogenic shock was induced by 1-h ligation of the left anterior descending (LAD) artery followed by reperfusion. Pigs were monitored with a Swan-Ganz catheter, a transpulmonary thermodilution catheter, and a conductance catheter placed in the left ventricle for pressure-loop measurements. Measurements were performed before LAD occlusion, 1 h after LAD occlusion, and 4 h after myocardial reperfusion.

RESULTS:

Myocardial infarction and reperfusion was followed by cardiogenic shock characterized by a significant increase in heart rate and significant decreases in mean arterial pressure (MAP), mixed venous oxygen saturation (SVO2), left ventricular end-diastolic pressure (LVEDP), prerecruitable stroke work (PRSW), and cardiac power index (CPI). Lactate levels were significantly increased. The systemic vascular resistance index (SVRI) and global end-diastolic volume index (GEDVI) remained unchanged. When compared with the control group (n = 6), norepinephrine infusion (n = 6) was associated with no changes in heart rate, a significant increase in MAP, SVO2, left ventricular ejection fraction, pressure development during isovolumic contraction, SVRI, and CPI and a decrease in lactate level. Cardiac index tended to increase (P = 0.059), whereas PRSW did not change in the norepinephrine group. LVEDP and GEDVI remained unchanged.

CONCLUSIONS:

Norepinephrine alone is able to improve hemodynamics, cardiac function, and tissue oxygenation in a pig model of ischemic cardiogenic shock.

• Authors: Alexandra Beurton, Nicolas Ducrocq, Thomas Auchet, Frédérique Joineau-Groubatch, Aude Falanga, Antoine Kimmoun, Nicolas Girerd, Renaud Fay, Fabrice Vanhuyse, Nguyen Tran, Bruno Levy
• Journal: Shock (Augusta, Ga.) (Shock) Vol. 46 Issue 2 Pg. 214-8 (08 2016) ISSN: 1540-0514 [Electronic] United States
• PMID: 26849625 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Norepinephrine

Topics

• Animals
• Arterial Pressure (drug effects)
• Blood Pressure (drug effects)
• Cardiac Output (drug effects)
• Heart Rate (drug effects)
• Hemodynamics (drug effects)
• Male
• Norepinephrine (therapeutic use)
• Oxygen Consumption (drug effects)
• Shock, Cardiogenic (drug therapy)
• Swine
• Ventricular Function, Left (drug effects)