Abstract | AIM: METHODS: We performed a randomized controlled study in which 40 healthy male volunteers were assigned to a 5-h infusion of either 0.05 μg/kg/min norepinephrine (n = 10), 0.5 μg/kg/min phenylephrine (n = 10), 0.04 IU/min vasopressin (n = 10), or saline (n = 10), starting 1 h before intravenous administration of 2 ng/kg lipopolysaccharide (LPS). The macrocirculation was monitored using arterial catheter-derived parameters with additional blood pressure waveform contour analysis (PCA) until 4.5 h following LPS administration. Sublingual microcirculatory density and flow were assessed using a handheld video microscope until 6 h post-LPS. RESULTS: LPS administration affected all macrocirculatory and microcirculatory parameters. The LPS-induced decrease in blood pressure and systemic vascular resistance (SVR) was refractory to low-dose norepinephrine and phenylephrine, and to a lesser extent, to vasopressin. Only vasopressin exerted effects on PCA parameters compared with placebo, by mitigating the LPS-induced decrease in diastolic blood pressure by stabilizing SVR and cardiac output. The endotoxemia-induced decreased indices of microvascular flow and density were not influenced by vasopressor therapy. CONCLUSIONS: In a highly controlled model of systemic inflammation in humans in vivo, a 5-h infusion of various vasopressors revealed distinctive effects on macrohemodynamic variables without affecting the sublingual microcirculation.
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Authors | Lex M van Loon, Roeland F Stolk, Johannes G van der Hoeven, Peter H Veltink, Peter Pickkers, Joris Lemson, Matthijs Kox |
Journal | Shock (Augusta, Ga.)
(Shock)
Vol. 53
Issue 2
Pg. 171-174
(02 2020)
ISSN: 1540-0514 [Electronic] United States |
PMID | 31008870
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Lipopolysaccharides
- Vasoconstrictor Agents
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Topics |
- Adolescent
- Adult
- Blood Pressure
(drug effects)
- Humans
- Inflammation
(chemically induced, physiopathology)
- Lipopolysaccharides
(pharmacology)
- Male
- Microcirculation
(drug effects)
- Vasoconstrictor Agents
(pharmacology)
- Young Adult
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