Journal
CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY
Volume 42, Issue 7, Pages 740-746Publisher
WILEY
DOI: 10.1111/1440-1681.12421
Keywords
cerebral blood flow; endotoxin; lipopolysac-charide; sepsis; sepsis-associated encephalopathy; vasopressor
Categories
Funding
- Foundation of Merchant Jakob Ehrenreich and Grete Ehrenreich
- Foundation of 1870
- Toyota Foundation
- Christian Larsen and Judge Ella Larsen's Grant
- Classen Trust Jubilee Foundation
- P. Carl Petersen Foundation
- University Hospital Rigshospitalet
- Faculty of Health Sciences, University of Copenhagen
- Danish Council for Independent Research - Medical Sciences
- Commission of the European Communities [223576 - MYOAGE]
- Danish Ministry of Science, Technology, and Innovation
- Danish Council for Strategic Research [09-067009, 09-075724]
Ask authors/readers for more resources
Vasopressor support is used widely for maintaining vital organ perfusion pressure in septic shock, with implications for dynamic cerebral autoregulation (dCA). This study investigated whether a noradrenaline-induced steady state increase in mean arterial blood pressure (MAP) would enhance dCA following lipopolysaccharide (LPS) infusion, a human-experimental model of the systemic inflammatory response during early sepsis. The dCA in eight healthy males was examined prior to and during an intended noradrenaline-induced MAP increase of approximately 30mmHg. This was performed at baseline and repeated after a 4-h intravenous LPS infusion. The assessments of dCA were based on transfer function analysis of spontaneous oscillations between MAP and middle cerebral artery blood flow velocity measured by transcranial Doppler ultrasound in the low frequency range (0.07-0.20Hz). Prior to LPS, noradrenaline administration was associated with a decrease in gain (1.18 (1.12-1.35) vs 0.93 (0.87-0.97) cm/mmHg per s; P<0.05) with no effect on phase (0.71 (0.93-0.66) vs 0.94 (0.81-1.10) radians; P=0.58). After LPS, noradrenaline administration changed neither gain (0.91 (0.85-1.01) vs 0.87 (0.81-0.97) cm/mmHg per s; P=0.46) nor phase (1.10 (1.04-1.30) vs 1.37 (1.23-1.51) radians; P=0.64). The improvement of dCA to a steady state increase in MAP is attenuated during an LPS-induced systemic inflammatory response. This may suggest that vasopressor treatment with noradrenaline offers no additional neuroprotective effect by enhancing dCA in patients with early sepsis.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available