Your browser doesn't support javascript.
loading
Effects of dexmedetomidine on hemodynamic, oxygenation, microcirculation, and inflammatory markers in a porcine model of sepsis
Carnicelli, Paulo; Otsuki, Denise Aya; Monteiro Filho, Adalberto; Kahvegian, Marcia Aparecida Portela; Ida, Keila Kazue; Auler-Junior, José Otavio Costa; Rouby, Jean-Jacques; Fantoni, Denise Tabacchi.
  • Carnicelli, Paulo; Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia. Surgery Department. São Paulo. BR
  • Otsuki, Denise Aya; Universidade de São Paulo. Hospital das Clínicas da Faculdade de Medicina. LIM08-Laboratory of Anesthesiology. São Paulo. BR
  • Monteiro Filho, Adalberto; Clínica Ufape. Veterinary Intensive Care Unit. Garanhuns. BR
  • Kahvegian, Marcia Aparecida Portela; All Care Vet. Sao Paulo. BR
  • Ida, Keila Kazue; Texas A&M University. College of Veterinary Medicine and Biomedical Sciences. Department of Small Animal Clinical Sciences. College Station. US
  • Auler-Junior, José Otavio Costa; Universidade de São Paulo. Hospital das Clínicas da Faculdade de Medicina. Laboratory of Anesthesiology. São Paulo. BR
  • Rouby, Jean-Jacques; Medicine Sorbonne University. La Pitié Salpêtrière Hospital. Department of Anaesthesiology and Critical Care. Paris. FR
  • Fantoni, Denise Tabacchi; Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia. Surgery Department. São Paulo. BR
Acta cir. bras ; 37(7): e370703, 2022. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1402969
ABSTRACT

Purpose:

To determine whether dexmedetomidine aggravates hemodynamic, metabolic variables, inflammatory markers, and microcirculation in experimental septic shock.

Methods:

Twenty-four pigs randomized into Sham group (n = 8), received saline; Shock group (n = 8), received an intravenous infusion of Escherichia coli O55 (3 × 109 cells/mL, 0.75 mL/kg, 1 hour); Dex-Shock group (n = 8), received bacteria and intravenous dexmedetomidine (bolus 0.5 mcg/kg followed by 0.7 mcg/kg/h). Fluid therapy and/ornorepinephrine were administered to maintain a mean arterial pressure > 65 mmHg. Hemodynamic, metabolic, oxygenation, inflammatory markers, and microcirculation were assessed at baseline, at the end of bacterial infusion, and after 60, 120, 180, and 240 minutes.

Results:

Compared to Shock group, Dex-Shock group presented a significantly increased oxygen extraction ratio at T180 (23.1 ± 9.7 vs. 32.5 ± 9.2%, P = 0.0220), decreased central venous pressure at T120 (11.6 ± 1 vs. 9.61 ± 1.2 mmHg, P = 0.0214), mixed-venous oxygen saturation at T180 (72.9 ± 9.6 vs. 63.5 ± 9.2%, P = 0.026), and increased plasma lactate (3.7 ± 0.5 vs. 5.5 ± 1 mmol/L, P = 0.003). Despite the Dex-Shock group having a better sublingual vessel density at T240 (12.5 ± 0.4 vs. 14.4 ± 0.3 mL/m2; P = 0.0003), sublingual blood flow was not different from that in the Shock group (2.4 ± 0.2 vs. 2.4 ± 0.1 mL/kg, P = 0.4418).

Conclusions:

Dexmedetomidine did not worsen the hemodynamic, metabolic, inflammatory, or sublingual blood flow disorders resulting from septic shock. Despite inducing a better sublingual vessel density, dexmedetomidine initially and transitorily increased the mismatch between oxygen supply and demand.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Shock, Septic / Swine / Dexmedetomidine / Microcirculation Type of study: Controlled clinical trial / Prognostic study Limits: Animals Language: English Journal: Acta cir. bras Year: 2022 Type: Article Institution/Affiliation country: All Care Vet/BR / Clínica Ufape/BR / Medicine Sorbonne University/FR / Texas A&M University/US / Universidade de São Paulo/BR

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Index: LILACS (Americas) Main subject: Shock, Septic / Swine / Dexmedetomidine / Microcirculation Type of study: Controlled clinical trial / Prognostic study Limits: Animals Language: English Journal: Acta cir. bras Year: 2022 Type: Article Institution/Affiliation country: All Care Vet/BR / Clínica Ufape/BR / Medicine Sorbonne University/FR / Texas A&M University/US / Universidade de São Paulo/BR