Abstract
Objective
To determine the effects of increasing dosages of continuously infused arginine-vasopressin (AVP) on mucosal tissue oxygen tension and oxygen supply in an auto-perfused, innervated jejunal segment in an acute endotoxic porcine model.
Design
Prospective, randomized, experimental study.
Setting
University hospital animal research laboratory.
Interventions
Jejunal mucosal tissue PO2 was measured employing two Clark-type surface oxygen electrodes. Oxygen saturation of jejunal microvascular hemoglobin was determined by tissue reflectance spectrophotometry. Systemic hemodynamic variables, mesenteric-venous and systemic acid base and blood gas variables and lactate measurements were recorded. Measurements were performed at baseline, after E. coli lipopolysaccharide (LPS) administration and at 20 min intervals during incremental AVP infusion ( n =8; 0.014, 0.029, 0.057, 0.114 and 0.229 IU kg-1 h-1, respectively) or infusion of saline ( n =8).
Measurements and results
LPS infusion leads to a significant ( P <0.05) decrease of mucosal tissue oxygen tension (PO2muc, 24±3 to 12±2 mmHg) and microvascular hemoglobin oxygen saturation (HbO2, 38±4 to 21±4%). Mesenteric venous lactate level increased (2.4±0.3 to 4.7±1.7 mmol l-1), while mesenteric venous pH decreased (7.38±0.02 to 7.26±0.12), indicating tissue hypoxia. AVP significantly increased mean arterial pressure (MAP, 81±15 to 97±17 at 0.057 IU kg-1 h-1). No differences in jejunal mucosal oxygenation occurred between study groups at any dosage during the experimental protocol.
Conclusion
AVP administration did not further compromise mucosal tissue oxygen tension and oxygen supply in the acute phase of endotoxic pigs.
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References
Dunser MW, Mayr AJ, Ulmer H, Knotzer H, Sumann G, Pajk W, Friesenecker B, Hasibeder WR (2003) Arginine vasopressin in advanced vasodilatory shock: a prospective, randomized, controlled study. Circulation 107:2313–2319
Bjarnason I, MacPherson A, Hollander D (1995) Intestinal permeability: an overview. Gastroenterology 108:1566–1581
Alverdy JC, Laughlin RS, Wu L (2003) Influence of the critically ill state on host-pathogen interactions within the intestine: gut-derived sepsis redefined. Crit Care Med 31:598–607
Marshall JC, Christou NV, Meakins JL (1993) The gastrointestinal tract. The “undrained abscess” of multiple organ failure. Ann Surg 218:111–119
Hasibeder W, Germann R, Sparr H, Haisjackl M, Friesenecker B, Luz G, Pernthaler H, Pfaller K, Maurer H, Ennemoser O (1994) Vasomotion induces regular major oscillations in jejunal mucosal tissue oxygenation. Am J Physiol 266:G978–986
Martikainen TJ, Tenhunen JJ, Uusaro A, Ruokonen E (2003) The effects of vasopressin on systemic and splanchnic hemodynamics and metabolism in endotoxin shock. Anesth Analg 97:1756–1763
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
Knotzer H, Pajk W, Maier S, Ladurner R, Kleinsasser A, Wenzel V, Dunser MW, Ulmer H, Hasibeder WR (2005) Arginine-vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension. Am J Physiol 289:H168–73
Tarpey SB, Bennett T, Randall MD, Gardiner SM (1998) Differential effects of endotoxaemia on pressor and vasoconstrictor actions of angiotensin II and arginine vasopressin in conscious rats. Br J Pharmacol 123:1367–1374
Bennett T, Mahajan RP, March JE, Kemp PA, Gardiner SM (2004) Regional and temporal changes in cardiovascular responses to norepinephrine and vasopressin during continuous infusion of lipopolysaccharide in conscious rats. Br J Anaesth 93:400–407
Malay MB, Ashton JL, Dahl K, Savage EB, Burchell SA, Ashton RC Jr, Sciacca RR, Oliver JA, Landry DW (2004) Heterogeneity of the vasoconstrictor effect of vasopressin in septic shock. Crit Care Med 32:1327–1331
Lobo SM, De Backer D, Sun Q, Tu Z, Dimopoulos G, Preiser JC, Nagy N, Vray B, Vercruy V, Terzi RG (2003) Gut mucosal damage during endotoxic shock is due to mechanisms other than gut ischemia. J Appl Physiol 95:2047–2054
Asfar P, Hauser B, Ivanyi Z, Ehrmann U, Kick J, Albicini M, Vogt J, Wachter U, Bruckner UB, Radermacher P (2005) Low-dose terlipressin during long-term hyperdynamic porcine endotoxemia: Effects on hepatosplanchnic perfusion, oxygen exchange, and metabolism. Crit Care Med 33:373–380
Asfar P, Pierrot M, Veal N, Moal F, Oberti F, Croquet V, Douay O, Gallois Y, Saumet JL, Alquier P (2003) Low-dose terlipressin improves systemic and splanchnic hemodynamics in fluid-challenged endotoxic rats. Crit Care Med 31:215–220
Guzman JA, Rosado AE, Kruse JA (2003) Vasopressin vs norepinephrine in endotoxic shock: systemic, renal, and splanchnic hemodynamic and oxygen transport effects. J Appl Physiol 95:803–809
Germann R, Haisjackl M, Schwarz B, Deusch E, Meusburger S, Gruber E, Pajk W, Hausdorfer H, Bonatti J, Furtner B (1997) Inotropic treatment and intestinal mucosal tissue oxygenation in a model of porcine endotoxemia. Crit Care Med 25:1191–1197
Acknowledgements
This research was conducted with the financial support of the Österreichische Nationalbank, Jubiläumsfondsprojekt no. 11022.
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This article refers to the editorial http://dx.doi.org/10.1007/s00134-005-2867-y
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Knotzer, H., Maier, S., Dünser, M.W. et al. Arginine vasopressin does not alter mucosal tissue oxygen tension and oxygen supply in an acute endotoxemic pig model. Intensive Care Med 32, 170–174 (2006). https://doi.org/10.1007/s00134-005-2858-z
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DOI: https://doi.org/10.1007/s00134-005-2858-z