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Norepinephrine and vital organ blood flow during experimental hyperdynamic sepsis

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Abstract

Objective

To study the effect of norepinephrine (NE) infusion on cerebral, coronary, renal and mesenteric blood flow during sepsis.

Design and setting

Randomised placebo-controlled animal trial in the animal laboratory of university physiology institute.

Animals

Seven merino cross-ewes.

Interventions

Chronic implantation of flow probes (aorta, renal, mesenteric and coronary artery and sagittal sinus). Induction of sepsis by intravenous bolus of E. coli (3×109). After the onset of hyperdynamic sepsis sheep were randomly allocated to either NE (0.4 µg kg−1 min−1) or placebo for 6 h.

Measurements and results

E. coli induced hypotension, fever, oliguria, tachycardia and tachypnoea. It increased cardiac output and renal, mesenteric and coronary blood flows. Sagittal flow remained unchanged. Compared to placebo NE infusion restored mean arterial blood pressure and further increased cardiac output. The increases in renal, mesenteric and coronary blood flow were unaffected. Sagittal flow was also unaltered. Compared to placebo NE increased myocardial performance, mean urine output and creatinine clearance at 2 h.

Conclusions

We conclude that hyperdynamic sepsis increases blood flow to heart, gut and kidney and that NE further increases cardiac output, blood pressure, myocardial performance, and urine output and creatinine clearance while maintaining regional blood flow.

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Author information

Authors and Affiliations

  1. Howard Florey Institute, Parkville, Melbourne, Australia

    David Di Giantomasso & Clive N. May

  2. Department of Intensive Care and Department of Medicine, Melbourne University, Melbourne, Australia

    Rinaldo Bellomo

  3. Austin & Repatriation Medical Centre, 3084, Heidelberg, Melbourne, Australia

    Rinaldo Bellomo

Authors
  1. David Di Giantomasso
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  2. Clive N. May
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  3. Rinaldo Bellomo
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Corresponding author

Correspondence to Rinaldo Bellomo.

Additional information

This study was supported by an institute grant (no. 983001) from the National Health & Medical Research Council of Australia and by grants from the Intensive Care Foundation of the Australian and New Zealand Intensive Care Society, the Laerdal Foundation (Norway) and the ARMC Anaesthesia and Intensive Care Trust Fund.

An editorial regarding this article can be found in the same issue (http://dx.doi.org/10.1007/s00134-003-1794-z)

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Di Giantomasso, D., May, C.N. & Bellomo, R. Norepinephrine and vital organ blood flow during experimental hyperdynamic sepsis. Intensive Care Med 29, 1774–1781 (2003). https://doi.org/10.1007/s00134-003-1736-9

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  • DOI: https://doi.org/10.1007/s00134-003-1736-9

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