Influence of amrinone on tissue oxygenation of jejunal mucosa during endotoxemia

Citation
W. Schmidt et al., Influence of amrinone on tissue oxygenation of jejunal mucosa during endotoxemia, J SURG RES, 93(1), 2000, pp. 9-15
Citations number
41
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
JOURNAL OF SURGICAL RESEARCH
ISSN journal
0022-4804 → ACNP
Volume
93
Issue
1
Year of publication
2000
Pages
9 - 15
Database
ISI
SICI code
0022-4804(200009)93:1<9:IOAOTO>2.0.ZU;2-O
Abstract
Background The intestinal mucosa is the portion of the gut most susceptible to impaired perfusion and oxygen delivery. The phosphodiesterase (PDE) inh ibitor amrinone has been proposed to improve oxygen delivery and tissue per fusion during sepsis. The objective of this study was to investigate the ef fects of amrinone on arterial oxygenation (PaO2) and tissue oxygenation (Pt iO(2)) of jejunal mucosa during endotoxemia. Materials and methods. Forty anesthetized and ventilated rats were laparoto mized and a jejunal portion was exteriorized and fixed on a plexiglass stag e. The jejunum was punctured and a Clark-type microcatheter PO2 probe and a microthermocouple were placed on the mucosa to measure PtiO(2). The animal s were randomly assigned to receive one of the four treatments: infusion of Escherichia coli lipopolysaccharides (LPS, 2 mg/kg/h) without amrinone pre treatment (LPS group); infusion of LPS with amrinone pretreatment (40 mu g/ kg/min, start 30 min before LPS infusion, amrinone + LPS group); no treatme nt with either amrinone or LPS (control group); treatment with amrinone wit hout LPS infusion (amrinone group). Mean arterial pressure (MAP), heart rat e (HR), PaO2, and PtiO(2) were measured 30 min before and 0, 60, and 120 mi n after induction of endotoxemia. Results. MAP remained stable in the control and LPS groups. In the amrinone + LPS group MAP decreased within the first 30 min of amrinone infusion and decreased further during endotoxemia. PaO2 remained stable in the control group and decreased in the LPS group. This endotoxin-induced decrease in Pa O2 was attenuated in the amrinone + LPS group. The mucosal PtiO(2) decrease d in the LPS group but remained stable in both the control and amrinone + L PS groups. Conclusions. Pretreatment with amrinone was able to diminish a decrease in PaO2 during endotoxemia, indicating that pulmonary dysfunction was attenuat ed. Endotoxin-induced tissue hypoxia of the intestinal mucosa, however, cou ld be fully prevented, indicating that an additional improvement in comprom ised tissue perfusion had occurred, (C) 2000 Academic Press.