Effects of levosimendan and dobutamine in experimental acute endotoxemia : A preliminary controlled study

Objective: To test the hypothesis that levosimendan increases systemic and intestinal oxygen delivery (DO2) and prevents intramucosal acidosis in septic shock. Design: Prospective, controlled experimental study. Setting: University-based research laboratory. Subjects: Nineteen anesthetized, mechanic...

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Autores principales: Dubin, Arnaldo, Murias, Gastón, Sottile, Juan Pablo, Pozo, Mario Omar, Barán, Marcelo, Kanoore Edul, Vanina Siham, Canales, Héctor Saúl, Etcheverry, Graciela, Maskin, Bernardo, Estenssoro, Elisa
Formato: Articulo
Lenguaje:Inglés
Publicado: 2007
Materias:
Ciencias Médicas
Medicina
Levosimendan
Dobutamine
Septic shock
Oxygen transport
Lactate
Gastrointestinal tonometry
Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/133650
Aporte de:
SEDICI (UNLP) de Universidad Nacional de La Plata
id I19-R120-10915-133650
record_format dspace
institution Universidad Nacional de La Plata
institution_str I-19
repository_str R-120
collection SEDICI (UNLP)
language Inglés
topic Ciencias Médicas
Medicina
Levosimendan
Dobutamine
Septic shock
Oxygen transport
Lactate
Gastrointestinal tonometry
spellingShingle Ciencias Médicas
Medicina
Levosimendan
Dobutamine
Septic shock
Oxygen transport
Lactate
Gastrointestinal tonometry
Dubin, Arnaldo
Murias, Gastón
Sottile, Juan Pablo
Pozo, Mario Omar
Barán, Marcelo
Kanoore Edul, Vanina Siham
Canales, Héctor Saúl
Etcheverry, Graciela
Maskin, Bernardo
Estenssoro, Elisa
Effects of levosimendan and dobutamine in experimental acute endotoxemia : A preliminary controlled study
topic_facet Ciencias Médicas
Medicina
Levosimendan
Dobutamine
Septic shock
Oxygen transport
Lactate
Gastrointestinal tonometry
description Objective: To test the hypothesis that levosimendan increases systemic and intestinal oxygen delivery (DO2) and prevents intramucosal acidosis in septic shock. Design: Prospective, controlled experimental study. Setting: University-based research laboratory. Subjects: Nineteen anesthetized, mechanically ventilated sheep. Interventions: Endotoxin-treated sheep were randomly assigned to three groups: control (n = 7), dobutamine (10 μg/kg/min, n = 6) and levosimendan (100 μg/kg over 10 min followed by 100 μg/kg/h, n = 6) and treated for 120 min. Measurements and main results: After endotoxin administration, systemic and intestinal DO 2 decreased (24.6 ± 5.2 vs 15.3 ± 3.4 ml/kg/min and 105.0 ± 28.1 vs 55.8 ± 25.9 ml/kg/min, respectively; p < 0.05 for both). Arterial lactate and the intramucosal–arterial PCO2 difference (∆PCO2) increased (1.4 ± 0.3 vs 3.1 ± 1.5 mmHg and 9 ± 6 vs 23 ± 6 mmHg mmol/l, respectively; p < 0.05). Systemic DO 2 was preserved in the dobutamine-treated group (22.3 ± 4.7 vs 26.8 ± 7.0 ml/min/kg, p = NS) but intestinal DO 2 decreased (98.9 ± 0.2 vs 68.0 ± 22.9 ml/min/kg, p < 0.05) and ∆PCO 2 increased (12 ± 5 vs 25 ± 11 mmHg, p < 0.05). The administration of levosimendan prevented declines in systemic and intestinal DO 2 (25.1 ± 3.0 vs 24.0 ± 6.3 ml/min/kg and 111.1 ± 18.0 vs 98.2 ± 23.1 ml/min/kg, p = NS for both) or increases in ∆PCO2 (7 ± 7 vs 10 ± 8, p = NS). Arterial lactate increased in both the dobutamine and levosimendan groups (1.6 ± 0.3 vs 2.5 ± 0.7 and 1.4 ± 0.4 vs. 2.9 ± 1.1 mmol/l, p = NS between groups). Conclusions: Compared with dobutamine, levosimendan increased intestinal blood flow and diminished intramucosal acidosis in this experimental model of sepsis.
format Articulo
Articulo
author Dubin, Arnaldo
Murias, Gastón
Sottile, Juan Pablo
Pozo, Mario Omar
Barán, Marcelo
Kanoore Edul, Vanina Siham
Canales, Héctor Saúl
Etcheverry, Graciela
Maskin, Bernardo
Estenssoro, Elisa
author_facet Dubin, Arnaldo
Murias, Gastón
Sottile, Juan Pablo
Pozo, Mario Omar
Barán, Marcelo
Kanoore Edul, Vanina Siham
Canales, Héctor Saúl
Etcheverry, Graciela
Maskin, Bernardo
Estenssoro, Elisa
author_sort Dubin, Arnaldo
title Effects of levosimendan and dobutamine in experimental acute endotoxemia : A preliminary controlled study
title_short Effects of levosimendan and dobutamine in experimental acute endotoxemia : A preliminary controlled study
title_full Effects of levosimendan and dobutamine in experimental acute endotoxemia : A preliminary controlled study
title_fullStr Effects of levosimendan and dobutamine in experimental acute endotoxemia : A preliminary controlled study
title_full_unstemmed Effects of levosimendan and dobutamine in experimental acute endotoxemia : A preliminary controlled study
title_sort effects of levosimendan and dobutamine in experimental acute endotoxemia : a preliminary controlled study
publishDate 2007
url http://sedici.unlp.edu.ar/handle/10915/133650
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