1. Beneficial Effects of Norepinephrine Alone on Cardiovascular Function and Tissue Oxygenation in a Pig Model of Cardiogenic Shock
- Author
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Nicolas Girerd, Fabrice Vanhuyse, Antoine Kimmoun, Nicolas Ducrocq, Nguyen Tran, Alexandra Beurton, Renaud Fay, Aude Falanga, Frédérique Joineau-Groubatch, Thomas Auchet, Bruno Levy, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Réanimation Médicale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Faculté de Médecine [Nancy], Université de Lorraine (UL), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois
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Male ,MESH: Hemodynamics ,medicine.medical_specialty ,Cardiac output ,Mean arterial pressure ,Swine ,MESH: Arterial Pressure ,Shock, Cardiogenic ,Cardiac index ,Blood Pressure ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,MESH: Ventricular Function, Left ,Ventricular Function, Left ,Norepinephrine (medication) ,Norepinephrine ,03 medical and health sciences ,Oxygen Consumption ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Heart Rate ,MESH: Norepinephrine ,Internal medicine ,medicine ,Animals ,MESH: Animals ,Arterial Pressure ,MESH: Oxygen Consumption ,Myocardial infarction ,MESH: Heart Rate ,Cardiac Output ,MESH: Swine ,Ejection fraction ,business.industry ,Cardiogenic shock ,MESH: Cardiac Output ,Hemodynamics ,030208 emergency & critical care medicine ,MESH: Blood Pressure ,medicine.disease ,MESH: Shock, Cardiogenic ,MESH: Male ,3. Good health ,Preload ,Anesthesia ,Emergency Medicine ,Cardiology ,business ,medicine.drug - Abstract
International audience; INTRODUCTION:The present study was developed to investigate the effects of norepinephrine alone on hemodynamics and intrinsic cardiac function in a pig model of cardiogenic shock mimicking the clinical setting.METHODS:Cardiogenic shock was induced by 1-h ligation of the left anterior descending (LAD) artery followed by reperfusion. Pigs were monitored with a Swan-Ganz catheter, a transpulmonary thermodilution catheter, and a conductance catheter placed in the left ventricle for pressure-loop measurements. Measurements were performed before LAD occlusion, 1 h after LAD occlusion, and 4 h after myocardial reperfusion.RESULTS:Myocardial infarction and reperfusion was followed by cardiogenic shock characterized by a significant increase in heart rate and significant decreases in mean arterial pressure (MAP), mixed venous oxygen saturation (SVO2), left ventricular end-diastolic pressure (LVEDP), prerecruitable stroke work (PRSW), and cardiac power index (CPI). Lactate levels were significantly increased. The systemic vascular resistance index (SVRI) and global end-diastolic volume index (GEDVI) remained unchanged. When compared with the control group (n = 6), norepinephrine infusion (n = 6) was associated with no changes in heart rate, a significant increase in MAP, SVO2, left ventricular ejection fraction, pressure development during isovolumic contraction, SVRI, and CPI and a decrease in lactate level. Cardiac index tended to increase (P = 0.059), whereas PRSW did not change in the norepinephrine group. LVEDP and GEDVI remained unchanged.CONCLUSIONS:Norepinephrine alone is able to improve hemodynamics, cardiac function, and tissue oxygenation in a pig model of ischemic cardiogenic shock.
- Published
- 2016
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