Does ß2-adrenergic stimulation attenuate fluid extravasation during hypothermic cardiopulmonary bypass? An experimental study in pigs.
Perfusion
; 27(5): 426-34, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-22711715
ABSTRACT
OBJECTIVES:
Hypothermic cardiopulmonary bypass (CPB) is associated with increased fluid filtration, edema formation and, occasionally, organ dysfunction. Cold-induced reduction in endothelial barrier function may play a role. ß(2)-adrenergic activation elevates cellular cyclic adenosine monophosphate (cAMP) which maintains endothelial barrier properties. In this study, we tested whether ß-adrenergic stimulation could influence the increase in fluid extravasation observed during hypothermic CPB. MATERIALS ANDMETHODS:
Fourteen pigs randomly received terbutaline infusion (T-group) (n=7) or a control infusion (C-group) (n=7). All animals were given 60 min of normothermic CPB, followed by 90 min of hypothermic CPB. Fluid input and losses, plasma volume, colloid osmotic pressures (plasma, interstitial fluid), hematocrit, serum proteins and total tissue water content were measured and the fluid extravasation rates (FER) calculated. STATISTICS by SPSS. Values presented as mean ± SD. Repeated measure analysis of variance was performed and a t-test used when appropriate.RESULTS:
The commencement of normothermic CPB resulted in a 20% hemodilution, with an abrupt increase in fluid requirements during the first 10 min. FER increased from 0.18 (0.06) pre-bypass to 0.78 (0.27) ml/kg/min (T-group) (p=0.002) and from 0.16 (0.05) to 0.93 (0.26) ml/kg/min (C-group) (p<0.001) with no between-group differences. Thereafter, FER stabilized at a level of 0.32 (0.13) and 0.27 (0.14) ml/kg/min in the T-group and C-group, respectively. After the start of cooling, FER increased in the T-group to 0.55 (0.12) ml/kg/min (P=0.046) and in the C-group to 0.54 (0.13) ml/kg/min (P=0.006), with no between-group differences (P=0.738).CONCLUSION:
In the present experimental study, we were unable to demonstrate any clinically relevant modulating effect of terbutaline on fluid extravasation during hypothermic cardiopulmonary bypass.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Terbutalina
/
Ponte Cardiopulmonar
/
Receptores Adrenérgicos beta 2
/
Extravasamento de Materiais Terapêuticos e Diagnósticos
/
Agonistas de Receptores Adrenérgicos beta 2
/
Hipotermia Induzida
Tipo de estudo:
Etiology_studies
Limite:
Animals
Idioma:
En
Revista:
Perfusion
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Noruega