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Amrinone during porcine intraperitoneal sepsis
J B Hermiller1, J P Mehegan, V M Nadkarni
1Naval Medical Research Institute, Bethesda, MD 20814-5055.
Circulatory Shock
|June 1, 1991
Summary
Amrinone modestly improved oxygen delivery in hyperdynamic sepsis by causing vasodilation, but it is not an optimal first-line treatment due to limited effects on cardiac output and oxygen utilization.
Area of Science:
- Cardiovascular Pharmacology
- Critical Care Medicine
- Sepsis Pathophysiology
Background:
- Hyperdynamic sepsis is characterized by increased cardiac output and vasodilation.
- Hemodynamic stabilization is crucial in managing sepsis.
- Amrinone is a phosphodiesterase inhibitor with inotropic and vasodilatory effects.
Purpose of the Study:
- To evaluate the hemodynamic effects of intravenous amrinone in a minipig model of hyperdynamic sepsis.
- To assess amrinone's impact on oxygen delivery, utilization, and extraction during sepsis.
Main Methods:
- Seven Yucatan minipigs received amrinone intravenously during the hyperdynamic phase of induced sepsis.
- Hemodynamic variables, including cardiac index and vascular resistance, were continuously monitored.
- Pulmonary capillary wedge pressure was maintained to standardize ventricular filling pressure.
Main Results:
- Amrinone administration resulted in a modest increase in cardiac index without altering heart rate.
- Significant decreases in systemic and pulmonary vascular resistance were observed (P < 0.05).
- Oxygen delivery increased (P < 0.05), but oxygen utilization and extraction remained unchanged.
Conclusions:
- Amrinone induced vasodilation and a modest improvement in stroke volume index in this sepsis model.
- While oxygen delivery increased, amrinone's overall salutary effects were limited.
- Amrinone is not considered an optimal first-line agent for hemodynamic stabilization in hyperdynamic sepsis.