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Titolo:
Specific angiotensin II receptor blockade improves intestinal perfusion during graded hypovolemia in pigs
Autore:
Aneman, A; Svensson, M; Broome, M; Biber, B; Petterson, A; Fandriks, L;
Indirizzi:
Univ Gothenburg, Dept Anesthesiol & Intens Care, Gothenburg, Sweden Univ Gothenburg Gothenburg Sweden iol & Intens Care, Gothenburg, Sweden Univ Gothenburg, Dept Physiol, Gothenburg, Sweden Univ Gothenburg Gothenburg Sweden urg, Dept Physiol, Gothenburg, Sweden Univ Gothenburg, Dept Clin Pharmacol, Gothenburg, Sweden Univ Gothenburg Gothenburg Sweden pt Clin Pharmacol, Gothenburg, Sweden Univ Gothenburg, Ctr Gastroenterol Res, Gothenburg, Sweden Univ Gothenburg Gothenburg Sweden Gastroenterol Res, Gothenburg, Sweden Umea Univ, Dept Anesthesiol, Umea, Sweden Umea Univ Umea SwedenUmea Univ, Dept Anesthesiol, Umea, Sweden
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 3, volume: 28, anno: 2000,
pagine: 818 - 823
SICI:
0090-3493(200003)28:3<818:SAIRBI>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
LASER-DOPPLER FLOWMETRY; BACTERIAL TRANSLOCATION; CARDIOGENIC-SHOCK; THERMAL-INJURY; VASOCONSTRICTION; VASOPRESSIN; HEMORRHAGE; CAPTOPRIL; HUMANS;
Keywords:
intestinal circulation; hemorrhage; renin-angiotensin system; angiotensin II; receptor blockade;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Aneman, A Sahlgrens Univ Hosp, Dept Anesthesiol & Intens Care, S-41385 Gothenburg, Sweden Sahlgrens Univ Hosp Gothenburg Sweden S-41385 thenburg, Sweden
Citazione:
A. Aneman et al., "Specific angiotensin II receptor blockade improves intestinal perfusion during graded hypovolemia in pigs", CRIT CARE M, 28(3), 2000, pp. 818-823

Abstract

Objective: To investigate the potential of specific angiotensin II subtype1 (AT1) receptor blockade to modify the mesenteric hemodynamic response toacute hypovolemia and retransfusion. Design: Prospective, randomized, controlled experimental study. Setting: University-affiliate animal research laboratory. Subjects: Fasted, anesthetized, ventilated, juvenile domestic pigs of bothsexes. Interventions: Acute, graded hypovolemia by 20% and 40% of the total estimated blood volume followed by retransfusion in control animals (CTRL; n = 10) and animals pretreated with the AT1 receptor blocker candesartan (CAND; n = 10). Measurements and Main Results: Invasive monitoring of arterial and centralvenous blood pressures, cardiac output, portal venous blood flow, and jejunal mucosal blood flow. Blood gases were repeatedly analyzed to calculate oxygen delivery and consumption. Thirty minutes after each level of hypovolemia at 20% and 40%, cardiac output was decreased in CTRL animals from a baseline of 2.9 +/- 0.1 to 1.8 +/- 0.2 and 1.1 +/- 0.2 L/min, with no differences compared with CAND animals. Cardiac output was restored to 3.0 +/- 0.3 L/min 30 mins after retransfusion in CTRL animals, with no significant intergroup differences. Baseline portal venous blood Row (Q(MES)) and jejunal mucosal perfusion (PUJEJ) were greater in CAND animals compared with CTRL animals. During graded hypovolemia, CAND animals maintained Q(MES) and PUJEJ at significantly higher levels compared with CTRL animals, particularly after 40% hemorrhage (+221% and + 244%, respectively, relative to the mean values in CTRL animals). The same pattern was observed after retransfusion. Moreover, the calculated mesenteric critical oxygen delivery was significantly greater in CTRL animals (74 mL/min) compared with CAND animals (34 mL/min). No animals died in the CAND group, whereas four animals died during 40% hypovolemia or retransfusion in the CTRL group. Conclusions: Specific AT1 blockade before acute hypovolemia significantly ameliorated mesenteric and, in particular, jejunal mucosal hypoperfusion. In addition, cardiovascular stability was improved, and mortality in conjunction with acute hypovolemia and retransfusion could be completely avoided. These findings support a fundamental role of the renin-angiotensin system in the mesenteric response to acute hypovolemia and indicate a substantial interventional potential for candesartan in conjunction with circulatory stress.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/01/20 alle ore 12:42:29