Effects of dexmedetomidine on hemodynamic, oxygenation, microcirculation, and inflammatory markers in a porcine model of sepsis
Acta cir. bras
; 37(7): e370703, 2022. tab, graf, ilus
Article
en En
| LILACS, VETINDEX
| ID: biblio-1402969
Biblioteca responsable:
BR68.1
ABSTRACT
Purpose:
To determine whether dexmedetomidine aggravates hemodynamic, metabolic variables, inflammatory markers, and microcirculation in experimental septic shock.Methods:
Twenty-four pigs randomized into Sham group (n = 8), received saline; Shock group (n = 8), received an intravenous infusion of Escherichia coli O55 (3 × 109 cells/mL, 0.75 mL/kg, 1 hour); Dex-Shock group (n = 8), received bacteria and intravenous dexmedetomidine (bolus 0.5 mcg/kg followed by 0.7 mcg/kg/h). Fluid therapy and/ornorepinephrine were administered to maintain a mean arterial pressure > 65 mmHg. Hemodynamic, metabolic, oxygenation, inflammatory markers, and microcirculation were assessed at baseline, at the end of bacterial infusion, and after 60, 120, 180, and 240 minutes.Results:
Compared to Shock group, Dex-Shock group presented a significantly increased oxygen extraction ratio at T180 (23.1 ± 9.7 vs. 32.5 ± 9.2%, P = 0.0220), decreased central venous pressure at T120 (11.6 ± 1 vs. 9.61 ± 1.2 mmHg, P = 0.0214), mixed-venous oxygen saturation at T180 (72.9 ± 9.6 vs. 63.5 ± 9.2%, P = 0.026), and increased plasma lactate (3.7 ± 0.5 vs. 5.5 ± 1 mmol/L, P = 0.003). Despite the Dex-Shock group having a better sublingual vessel density at T240 (12.5 ± 0.4 vs. 14.4 ± 0.3 mL/m2; P = 0.0003), sublingual blood flow was not different from that in the Shock group (2.4 ± 0.2 vs. 2.4 ± 0.1 mL/kg, P = 0.4418).Conclusions:
Dexmedetomidine did not worsen the hemodynamic, metabolic, inflammatory, or sublingual blood flow disorders resulting from septic shock. Despite inducing a better sublingual vessel density, dexmedetomidine initially and transitorily increased the mismatch between oxygen supply and demand.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
/
VETINDEX
Asunto principal:
Choque Séptico
/
Porcinos
/
Dexmedetomidina
/
Microcirculación
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Animals
Idioma:
En
Revista:
Acta cir. bras
Asunto de la revista:
CIRURGIA GERAL
/
Procedimentos Cir£rgicos Operat¢rios
Año:
2022
Tipo del documento:
Article
País de afiliación:
Brasil
/
Francia
/
Estados Unidos
Pais de publicación:
Brasil