Di Giantomasso David, May Clive N, Bellomo Rinaldo
Howard Florey Institute, Parkville, Melbourne, Australia.
Intensive Care Med. 2003 Oct;29(10):1774-81. doi: 10.1007/s00134-003-1736-9. Epub 2003 Apr 16.
To study the effect of norepinephrine (NE) infusion on cerebral, coronary, renal and mesenteric blood flow during sepsis.
Randomised placebo-controlled animal trial in the animal laboratory of university physiology institute.
Seven merino cross-ewes.
Chronic implantation of flow probes (aorta, renal, mesenteric and coronary artery and sagittal sinus). Induction of sepsis by intravenous bolus of E. coli (3 x 10(9)). After the onset of hyperdynamic sepsis sheep were randomly allocated to either NE (0.4 microg kg(-1) min(-1)) or placebo for 6 h.
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.
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.
研究去甲肾上腺素（NE）输注对脓毒症期间脑、冠状动脉、肾和肠系膜血流的影响。
在大学生理研究所动物实验室进行的随机安慰剂对照动物试验。
7只美利奴杂交母羊。
长期植入血流探头（主动脉、肾、肠系膜和冠状动脉以及矢状窦）。通过静脉推注大肠杆菌（3×10⁹）诱导脓毒症。在高动力性脓毒症发作后，将绵羊随机分为NE组（0.4微克·千克⁻¹·分钟⁻¹）或安慰剂组，持续6小时。
大肠杆菌诱导低血压、发热、少尿、心动过速和呼吸急促。它增加了心输出量以及肾、肠系膜和冠状动脉血流。矢状窦血流保持不变。与安慰剂相比，NE输注恢复了平均动脉血压，并进一步增加了心输出量。肾、肠系膜和冠状动脉血流的增加未受影响。矢状窦血流也未改变。与安慰剂相比，NE在2小时时增加了心肌功能、平均尿量和肌酐清除率。
我们得出结论，高动力性脓毒症增加了心脏、肠道和肾脏的血流，并且NE在维持局部血流的同时进一步增加了心输出量、血压、心肌功能、尿量和肌酐清除率。
