Effects of norepinephrine and dopamine on kidney during endotoxin shock in dogs / 中华麻醉学杂志

ABSTRACT

Objective To assess the effects of norephrine and dopamine on renal blood and renal function in a dog model of endotoxin shock. Methods Twenty-one mongrel dogs (weight 14-30 kg) were anesthetized with pentobarbital sodium and intubated. Spontaneous breathing was maintained. Swan-Ganz catheter was inserted via right external jugular vein. A 18G cannula was inserted via vein of the left upper limb for infusion of fluid and a 20G cannula in femoral artery for blood sampling and monitoring of arterial pressure. Abdomen was opened and right renal artery was exposed. A electromagnetic flowmeter (4mmφin interval diameter) was placed around the renal artery for measurement of renal blood flow. Shock was induced with intravenous administration of endotoxin 2mg/kg (LPS O55B5 Sigma). One hour after iv injection of LPS, the animals were divided into 3 groups with 7 dogs each group Ⅰ (group NE) received norepinephrine infusion 40ng@ kg-1@ min-1 for 1h; group Ⅱ (group DA) received dopamine infusion 4μg.kg-1 @min-1 for 1h; group Ⅲ (group NE + DA) received NE 40 ng@ kg-1 @min-1 and 4 μg@ kg-1@min-1 for 1h. MAP, HR, cardiac output(CO), stroke volume index(SVI), CVP, PCVP, SVR, renal blood flow and renal function (serum Na+ , K+ , creatinine, urea nitrogen and uric acid ) were measured before LPS administration, lh after administration of LPS, at the end of norepinephrine and/or dopamine infusion, 1 and 2h after NE and/or DA infusion. Results MAP, CO and renal blood flow decreased significantly after LPS administration, but there was no significant change in renal function after LPS was given. After infusion of norepinephrine and/or dopamine MAP, SVI and CO increased significantly but there was little change in renal blood flow and renal function. Conclusions Low dose norepinephrine can improve hemodynamics and maintain renal blood flow and renal function especially when combined with dopamine during endotoxin shock in dogs.