Balk R A, Jacobs R F, Tryka A F, Walls R C, Bone R C
Department of Medicine, University of Arkansas for Medical Sciences, Little Rock.
Crit Care Med. 1988 Nov;16(11):1128-31. doi: 10.1097/00003246-198811000-00009.
The dose response of the nonsteroidal anti-inflammatory drug, ibuprofen, was evaluated in order to determine the most efficacious dose in the treatment of canine endotoxin shock. Fifteen minutes after an infusion of Escherichia coli endotoxin, four groups of dogs were given a single iv dose of 1, 5, 10, or 20 mg/kg of ibuprofen. These groups were compared to endotoxin only and saline control groups. All ibuprofen doses significantly improved the systolic, diastolic, and mean systemic arterial BP. The improvement in systemic BP was accompanied by an increase in the systemic vascular resistance. Pulmonary vascular pressures and resistance also increased after ibuprofen administration. The lack of a dose response and the demonstrated beneficial effect of low dose ibuprofen in the reversal of the hypotension associated with experimental canine endotoxin shock lead us to recommend the use of low dose ibuprofen for future endotoxin and sepsis studies. Use of low dose ibuprofen might have less of an effect on renal perfusion and would therefore be more likely to produce the beneficial hemodynamic response without compromising renal function.
为了确定治疗犬内毒素休克的最有效剂量,对非甾体抗炎药布洛芬的剂量反应进行了评估。在输注大肠杆菌内毒素15分钟后,给四组犬静脉注射单剂量1、5、10或20mg/kg的布洛芬。将这些组与仅注射内毒素的组和生理盐水对照组进行比较。所有布洛芬剂量均显著改善了收缩压、舒张压和平均体动脉血压。体循环血压的改善伴随着体循环血管阻力的增加。布洛芬给药后肺血管压力和阻力也增加。缺乏剂量反应以及低剂量布洛芬在逆转与实验性犬内毒素休克相关的低血压方面显示出有益作用,这使我们建议在未来的内毒素和脓毒症研究中使用低剂量布洛芬。使用低剂量布洛芬可能对肾灌注影响较小,因此更有可能在不损害肾功能的情况下产生有益的血流动力学反应。