4.6 Article

The effect of mild endotoxemia during low arginine plasma levels on organ blood flow in rats

Journal

CRITICAL CARE MEDICINE
Volume 28, Issue 6, Pages 1991-1997

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00003246-200006000-00051

Keywords

arginase; arginine; endotoxin; microspheres; regional blood flow

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Objective: Arginine is the sole precursor in the generation of the vasodilating agent nitric oxide. Arginine plasma levels are low in situations associated with endotoxemia such as major trauma, sepsis, and experimental obstructive jaundice. The aim of the study was to evaluate hemodynamics at low arginine plasma levels during a low-grade endotoxemia. Design: Randomized, placebo-controlled animal laboratory investigation. Subjects: Male Wistar rats (n = 29), anesthetized. Interventions: Rats were randomly assigned to receive (at t = 0 mins) an intravenous infusion of 1.5 mt of 0.9% NaCl (SAL, n = 12) or 1.5 mt of an arginase (3200 IU) solution (ASE, n = 17) over a 20-min period. After the SAL or ASE infusion, rats were randomly assigned to receive an intravenous endotoxin (lipopolysaccharide [LPS], 150 mu g/kg in 1.0 mt of 0.9% NaCl; ASE/LPS, n = 10 and SAL/LPS, n = 6) challenge or a control infusion (1.0 mL of 0.9% NaCl; ASE/SAL, n = 7 and SAL/SAL, n = 6) at t = 30 mins. Measurements and Main Results:Organ blood flow was measured at t = 270 mins, using radiolabeled microspheres. At this time point, arginine plasma levels were lower in the ASE-treated rats (ASE/SAL vs. SAL/SAL and ASE/LPS vs. SAL/LPS, both p < .005, respectively). Cardiac output, mean arterial pressure, and therefore total peripheral resistance were similar for all groups. In the LPS-treated animals (SAL/LPS and ASE/LPS), cardiac output was maintained by a higher heart rate compensating the lower stroke volume, Organ blood flow to the small intestine and splanchnic blood flow was lower in the ASE/LPS-treated rats (both p < .05 when compared with of her groups). Total liver blood flow was similar for all groups; the lower splanchnic blood flow was compensated for by a higher hepatic arterial blood flow. Conclusion: The present study shows that low arginine plasma levels do not influence organ blood flow, whereas, during a low-grade endotoxemia, low arginine plasma levels result in reduced blood flow to the small intestine.

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