Microdialysis-evaluated myocardial cyclooxygenase-mediated inflammation and early circulatory depression in porcine endotoxemia

被引:34
作者
Mutschler, DK
Eriksson, MB [1 ]
Wikström, BG
Lind, L
Larsson, A
Bergren-Kiiski, R
Lagrange, A
Nordgren, A
Basu, S
机构
[1] Univ Uppsala Hosp, Dept Surg Sci, Inst Anesthesiol & Intens Care, SE-75185 Uppsala, Sweden
[2] Univ Uppsala Hosp, Dept Med Sci, Inst Cardiol, Uppsala, Sweden
[3] Univ Uppsala Hosp, Inst Internal Med, Uppsala, Sweden
[4] Univ Uppsala Hosp, Inst Clin Chem, Uppsala, Sweden
[5] Univ Uppsala Hosp, Sect Geriatr, Uppsala, Sweden
[6] Univ Uppsala Hosp, Sect Clin Nutr, Uppsala, Sweden
关键词
cyclooxygenase; endotoxin; hemodynamic; inflammation; magnesium; microdialysis; porcine; prostaglandin; sepsis; septic shock;
D O I
10.1097/01.CCM.0000075740.61294.a6
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To evaluate the early myocardial biochemical inflammatory response with the microdialysis technique during porcine endotoxemia and to simultaneously monitor systemic hemodynamics. Design: Prospective, randomized, placebo-controlled trial with parallel groups. Setting. Animal research laboratory at the University Hospital of Uppsala, Sweden. Subjects. Thirteen piglets aged 12-14 wks receiving general anesthesia. Interventions. After thoracotomy and the insertion of microdialysis probes in standardized locations in the left ventricle of the heart and in the quadriceps muscle, seven pigs received a continuous infusion of endotoxin, initiating a severe endotoxemic shock. Six pigs received saline instead of endotoxin. Measurements and Main Results. Endotoxemia caused a rapid and pronounced elevation of a metabolite obtained from prostaglandin degradation, 15-keto-dihydro-PGF(2alpha), in myocardial microdialysate fluid being specific of cyclooxygenase (COX)-mediated inflammation (p < .001 vs. saline-infused controls). Simultaneously, we observed a decrease in left ventricular stroke work index in the endotoxemic pigs (p < .01 vs. saline-infused controls). Endotoxemia did not alter 15-keto-dihydro-PGF(2alpha) levels in quadriceps muscle. Endotoxemia caused increases in taurine, hypoxanthine, and magnesium in myocardial microdialysate (p < .05 vs. saline-infused controls), whereas the contents of pyruvate, lactate, inosine, adenosine, and calcium were not significantly changed. Conclusion: Endotoxemia induced a myocardial COX-mediated inflammation without signs of ischemia. In parallel, a depletion of myocardial energy substrates and a deterioration in myocardial performance were seen.
引用
收藏
页码:1780 / 1785
页数:6
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