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Nitric oxide in brain death related cardiovascular dysfunction

H B Bittner1, E P Chen, M I Geiger

  • 1Department of General and Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina, USA.

Journal of Critical Care
|March 1, 1996
PubMed
Summary

Brain death (BD) significantly impairs cardiac function and alters vascular resistance, but these early hemodynamic changes are not linked to major alterations in the nitric oxide (NO) pathway. NO may not be a key factor in the initial response to BD.

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Area of Science:

  • Cardiovascular Physiology
  • Neuroscience
  • Biochemistry

Background:

  • Nitric oxide (NO) is crucial for regulating vascular tone, blood pressure, and blood flow.
  • Hemodynamic alterations are characteristic of various disease states.
  • The specific role of NO in the context of brain death (BD) remains unevaluated.

Purpose of the Study:

  • To investigate the role of nitric oxide (NO) in the hemodynamic and cardiac functional changes following brain death (BD).
  • To assess changes in NO pathway markers and cardiac function in a canine model of BD.

Main Methods:

  • Mongrel dogs underwent induction of brain death (BD).
  • Serum nitrite, L-arginine, and myocardial NO extraction were measured at various time points post-BD.
  • Cardiac function and pulmonary vasculature flow characteristics were analyzed using micromanometers, flow probes, and dimension transducers.

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Main Results:

  • Right and left ventricular function significantly deteriorated after BD.
  • Pulmonary and systemic vascular resistance, along with pulmonary impedance, decreased post-BD.
  • Serum L-arginine levels decreased, while myocardial NO extraction remained unchanged, indicating no major NO pathway alterations.

Conclusions:

  • Early decreases in vascular resistance and cardiac function following BD are not associated with significant changes in the NO pathway.
  • Nitric oxide (NO) does not appear to play a critical role in the initial hemodynamic and functional changes observed after brain death.