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Titolo:
Reduced regional and global cerebral blood flow during fenoldopam-induced hypotension in volunteers
Autore:
Prielipp, RC; Wall, MH; Groban, L; Tobin, JR; Fahey, FH; Harkness, BA; Stump, DA; James, RL; Cannon, MA; Bennett, J; Butterworth, J;
Indirizzi:
Wake Forest Univ, Sch Med, Dept Anesthesiol, Sect Crit Care, Winston Salem, NC 27157 USA Wake Forest Univ Winston Salem NC USA 27157 , Winston Salem, NC 27157 USA Wake Forest Univ, Sch Med, Dept Anesthesiol, Sect Cardiothorac Anesthesiol, Winston Salem, NC 27157 USA Wake Forest Univ Winston Salem NC USA 27157 , Winston Salem, NC 27157 USA Wake Forest Univ, Sch Med, Dept Radiol, Winston Salem, NC 27157 USA Wake Forest Univ Winston Salem NC USA 27157 , Winston Salem, NC 27157 USA
Titolo Testata:
ANESTHESIA AND ANALGESIA
fascicolo: 1, volume: 93, anno: 2001,
pagine: 45 - 52
SICI:
0003-2999(200107)93:1<45:RRAGCB>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSCRANIAL DOPPLER; SODIUM-NITROPRUSSIDE; RECEPTOR SUBTYPES; DOPAMINE; AGONIST; MICROCIRCULATION; HYPERTENSION; PRESSURE; DA-1; DOG;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Prielipp, RC Wake Forest Univ, Sch Med, Dept Anesthesiol, Sect Crit Care, Med Ctr Blvd,Winston Salem, NC 27157 USA Wake Forest Univ Med Ctr Blvd Winston Salem NC USA 27157 USA
Citazione:
R.C. Prielipp et al., "Reduced regional and global cerebral blood flow during fenoldopam-induced hypotension in volunteers", ANESTH ANAL, 93(1), 2001, pp. 45-52

Abstract

Dopamine has a wide spectrum of receptor and pharmacologic actions that may affect cerebral blood flow (CBF). A new, selective dopamine-1 agonist, fenoldopam, is a potent systemic vasodilator with moderate alpha (2)-receptoraffinity. However, the effects of fenoldopam on the cerebral circulation are undefined. We therefore hypothesized that infusion of fenoldopam would decrease mean arterial blood pressure (MAP) and might concurrently decrease CBF via vascular alpha (2)-adrenoreceptor activation in awake volunteers. We studied nine healthy normotensive subjects, using positron emission tomography to measure CBF in multiple cortical and subcortical regions of interest. In addition, bioimpedance cardiac output and middle cerebral artery blood flow velocity were determined during fenoldopam-induced hypotension. Three men and four women, aged 25-43 yr, completed the study. Fenoldopam infused at 1.3 +/- 0.4 mug. kg(-1). min(-1) (mean +/- SD) reduced MAP 16% from baseline: from 94 (89 -100) mm Hg (mean [95% confidence interval]) to 79 [74-85] mm Hg (P < 0.0001). During the fenoldopam infusion, both cardiac output (+39%), and heart rate (+45%) increased significantly, whereas global CBFdecreased from baseline, 45.6 [35.6-58.5] mL 100 g(-1).min(-1), to 37.7 [33.9-42.0] mL.100 g(-1).min(-1) (P < 0.0001). Despite restoration of baseline MAP with a concurrent infusion of phenylephrine, global CBF remained decreased relative to baseline values at 37.9 [34.0-42.3] mL.100.gm(-1) .min(-1) (P < 0.0001). Changes in middle cerebral artery velocity did not correlate with positron emission tomography-measured changes of CBF induced by fenoldopam, with or without concurrent phenylephrine.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/21 alle ore 12:35:54