Norepinephrine and vital organ blood flow

Abstract

Objective. To test whether norepinephrine (NE) infusion at 0.4 µg kg^–1 min^–1 adversely affects regional blood flow in the normal mammalian circulation.

Design and setting. Randomized cross-over experimental animal study in a university-affiliated physiology institute.

Subjects. Six merino ewes.

Interventions. Staged insertion of transit-time flow probes around the ascending aorta and circumflex coronary, superior mesenteric and left renal arteries. In conscious animals with chronically embedded flow probes randomization to either 6 h of placebo (saline) or drug (NE at 0.4 µg kg^–1 min^–1).

Measurements and results. Compared to placebo, NE significantly increased mean arterial pressure (84.4 vs. 103.8 mmHg), heart rate (61.0 vs. 74.6 bpm) and cardiac output (3.76 vs. 4.78 l/min). These changes were associated with an increase in coronary blood flow (24.2 vs. 37.4 ml/min) and renal blood flow (215.2 vs. 282.0 ml/min) but no change in mesenteric blood flow. The increase in renal and coronary blood flow was associated with an increase in regional conductance (regional vasodilatation), while mesenteric conductance fell (mesenteric vasoconstriction). Urine output (91±17 vs. 491±360 ml/h) and creatinine clearance (61±18 vs. 89±12 ml/min) increased during NE infusion.

Conclusions. NE infusion does not induce vital organ ischaemia in the normal mammalian circulation. Furthermore, it results in a significant increase in coronary and renal blood flow with a concomitant improvement in urine output and creatinine clearance.