Temporary elimination of orthostatic hypotension by norepinephrine infusion
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- Goldstein, D.S., Sewell, L., Holmes, C. et al. Clin Auton Res (2012) 22: 303. doi:10.1007/s10286-012-0176-4
A cardinal manifestation of chronic autonomic failure is neurogenic orthostatic hypotension (OH), which often is associated with supine hypertension, posing a therapeutic dilemma. We report here success in a first step toward development of a “prosthetic baroreceptor system” to maintain blood pressure during orthostasis without worsening supine hypertension. In all of four patients with neurogenic OH, titrated i.v. NE infusion kept directly recorded intra-arterial pressure at or above baseline during progressive head-up tilt. We conclude that titrated i.v. NE infusion temporarily eliminates OH.
KeywordsNorepinephrineOrthostatic hypotensionSympathetic nervous systemBaroreflex