Abstract
Recent studies have demonstrated the importance of microcirculatory alterations in the early stage of sepsis [1–3]. The gastrointestinal tract, particularly perfusion of the splanchnic bed and the integrity of the gut mucosa, occupies a key position in the pathogenesis of multiple organ failure (MOF) in sepsis.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Nakajima Y, Baudry N, Duranteau J, Vicaut E (2001) Microcirculation in intestinal villi: a comparison between hemorrhagic and endotoxin shock. Am J Respir Crit Care Med 164:1526–1530
Sakr Y, Dubois MJ, De Backer D, Creteur J, Vincent JL (2004) Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock. Crit Care Med 32:1825–1831
De Backer D, Creteur J, Dubois MJ, et al (2006) The effects of dobutamine on microcirculatory alterations in patients with septic shock are independent of its systemic effects. Crit Care Med 34:403–408
Piagnerelli M, Boudjeltia KZ, Brohee D, et al (2003) Alterations of red blood cell shape and sialic acid membrane content in septic patients. Crit Care Med 31:2156–2162
Piagnerelli M, Boudjeltia KZ, Vanhaeverbeek M, Vincent JL (2003) Red blood cell rheology in sepsis. Intensive Care Med 29:1052–1061
Hollenberg SM, Ahrens TS, Annane D, et al (2004) Practice parameters for hemodynamic support of sepsis in adult patients: 2004 update. Crit Care Med 32:1928–1948
Martin C, Viviand X, Leone M, Thirion X (2000) Effect of norepinephrine on the outcome of septic shock. Crit Care Med 28:2758–2765
Patel BM, Chittock DR, Russell JA, Walley KR (2002) Beneficial effects of short-term vasopressin infusion during severe septic shock. Anesthesiology 96:576–582
Dunser MW, Mayr AJ, Ulmer H, et al (2003) Arginine vasopressin in advanced vasodilatory shock: a prospective, randomized, controlled study. Circulation 107:2313–2319
Buwalda M, Ince C (2002) Opening the microcirculation: can vasodilators be useful in sepsis? Intensive Care Med 28:1208–1217
Nakajima Y, Baudry N, Duranteau J, Vicaut E (2006) Effects of vasopressin, norepinephrine, and L-arginine on intestinal microcirculation in endotoxemia. Crit Care Med 34:1752–1757
Levy B, Vallee C, Lauzier F, et al (2004) Comparative effects of vasopressin, norepinephrine, and L-canavanine, a selective inhibitor of inducible nitric oxide synthase, in endotoxic shock. Am J Physiol Heart Circ Physiol 287:H209–215
Vallet B, Lund N, Curtis SE, Kelly D, Cain SM (1994) Gut and muscle tissue PO2 in endotoxemic dogs during shock and resuscitation. J Appl Physiol 76:793–800
Malay MB, Ashton JL, Dahl K, et al (2004) Heterogeneity of the vasoconstrictor effect of vasopressin in septic shock. Crit Care Med 32:1327–1331
Westphal M, Freise H, Kehrel BE, Bone HG, Van Aken H, Sielenkamper AW (2004) Arginine vasopressin compromises gut mucosal microcirculation in septic rats. Crit Care Med 32:194–200
Boerma EC, van der Voort PH, Ince C (2005) Sublingual microcirculatory flow is impaired by the vasopressin-analogue terlipressin in a patient with catecholamine-resistant septic shock. Acta Anaesthesiol Scand 49:1387–1390
Knotzer H, Pajk W, Maier S, et al (2005) Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension. Am J Physiol Heart Circ Physiol 289:H168–173
Knotzer H, Maier S, Dunser MW, et al (2006) Arginine vasopressin does not alter mucosal tissue oxygen tension and oxygen supply in an acute endotoxemic pig model. Intensive Care Med 32:170–174
Asfar P, Pierrot M, Veal N, et al (2003) Low-dose terlipressin improves systemic and splanchnic hemodynamics in fluid-challenged endotoxic rats. Crit Care Med 31:215–220
van Haren FM, Rozendaal FW, van der Hoeven JG (2003) The effect of vasopressin on gastric perfusion in catecholamine-dependent patients in septic shock. Chest 124:2256–2260
Klinzing S, Simon M, Reinhart K, Bredle DL, Meier-Hellmann A (2003) High-dose vasopressin is not superior to norepinephrine in septic shock. Crit Care Med 31:2646–2650
Morelli A, Rocco M, Conti G, et al (2004) Effects of terlipressin on systemic and regional haemodynamics in catecholamine-treated hyperkinetic septic shock. Intensive Care Med 30:597–604
Morelli A, Tritapepe L, Rocco M, et al (2005) Terlipressin versus norepinephrine to counteract anesthesia-induced hypotension in patients treated with renin-angiotensin system inhibitors: effects on systemic and regional hemodynamics. Anesthesiology 102:12–19
Dubois MJ, De Backer D, Creteur J, Anane S, Vincent JL (2003) Effect of vasopressin on sublingual microcirculation in a patient with distributive shock. Intensive Care Med 29:1020–1023
Spain DA, Wilson MA, Bar-Natan MF, Garrison RN (1994) Nitric oxide synthase inhibition aggravates intestinal microvascular vasoconstriction and hypoperfusion of bacteremia. J Trauma 36:720–725
Pastor CM, Payen DM (1994) Effect of modifying nitric oxide pathway on liver circulation in a rabbit endotoxin shock model. Shock 2:196–202
Lorente, JA, Delgado MA, Tejedor C, et al (1999) Modulation of systemic hemodynamics by exogenous L-arginine in normal and bacteremic sheep. Crit Care Med 27:2474–2479
Spronk PE, Ince C, Gardien MJ, Mathura KR, Oudemans-van Straaten HM, Zandstra DF (2002) Nitroglycerin in septic shock after intravascular volume resuscitation. Lancet 360:1395–1396
De Backer D (2006) L-arginine and vasopressor agents: when antagonists have unexpected synergistic effects. Crit Care Med 34:1847–1849
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer Science + Business Media Inc.
About this paper
Cite this paper
Pottecher, J., Deruddre, S., Duranteau, J. (2007). Effects of Vasoactive Agents on the Gastrointestinal Microcirculation in Septic Shock. In: Intensive Care Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 2007. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-49433-1_7
Download citation
DOI: https://doi.org/10.1007/978-3-540-49433-1_7
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-49432-4
Online ISBN: 978-3-540-49433-1
eBook Packages: MedicineMedicine (R0)