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Comparison between 6-week foam rolling intervention program with and without vibration on rolling and non-rolling sides. Eur J Appl Physiol 2022; 122:2061-2070. [PMID: 35704122 DOI: 10.1007/s00421-022-04975-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The chronic effects of unilateral foam rolling (FR) or FR with vibration (VFR) intervention on the rolling and non-rolling sides (cross-education effects) are still unclear. Thus, this study aimed to investigate the effects of unilateral 6-week FR or VFR intervention on ankle dorsiflexion range of motion (DF ROM), muscle stiffness, and muscle strength in both rolling and non-rolling sides. METHODS Thirty healthy young men were randomly allocated into the FR (n = 15) or the VFR intervention group (n = 15). Participants performed three sets of unilateral FR or VFR interventions for 60 s of the calf muscles twice/week, for 6 weeks. DF ROM, gastrocnemius muscle stiffness, and maximal voluntary isometric contraction (MVIC) torque were assessed in the rolling and non-rolling sides before and after the intervention. RESULTS The DF ROM increased significantly (p < 0.05) to the same extent in the FR and VFR intervention groups on both rolling (FR: d = 0.58, VFR: d = 0.63) and non-rolling (FR: d = 0.39, VFR: d = 0.50) sides. Similarly, the passive torque at DF ROM increased significantly (p < 0.05) to the same extent in the FR and VFR intervention groups on both rolling (FR: d = 0.85, VFR: d = 0.77) and non-rolling (FR: d = 0.76, VFR: d = 0.68) sides. However, there were no significant changes in muscle stiffness and MVIC after FR and VFR interventions on both the rolling and non-rolling sides. FR and VFR interventions could increase the ROM in both the rolling and non-rolling sides but could not change muscle stiffness and strength. CONCLUSIONS The results showed that it is not necessarily needed to perform VFR to increase ROM in the long term.
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Kavakli HS, Alici O, Koca C, Altintas ND, Aydin M. Effects of Erdosteine in Experimental Sepsis Model in Rats. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791101800503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Erdosteine is a mucolytic agent that is known to possess antioxidant effects. This study investigated the effects of erdosteine on endothelin-1 (ET-1) levels and oxidative stress parameters superoxide dismutase (SOD) and malondialdehyde (MDA) in a rat sepsis model. Methods Four groups of Wistar albino rats (n=8 per group) were randomly allocated to the following groups: sham (group 1), sepsis (group 2), erdosteine control (group 3) and a sepsis group pretreated with erdosteine (group 4). Sepsis was induced using E. Coli ATCC 25922 inoculation. Serum ET-1, liver tissue SOD and MDA levels were determined in all groups. Results ET-1 levels were significantly higher in group 2 compared to groups 1, 3 and 4 (p<0.001, p=0.002 and p<0.001, respectively). Similarly, MDA levels in groups 1, 3 and 4 were significantly lower relative to group 2 (p<0.001, p=0.022 and p=0.010, respectively). Additionally, SOD activities in these same three groups were found to be significantly higher than those in group 2 (p<0.001, p=0.004 and p=0.028, respectively). Conclusion In conclusion, erdosteine decreases ET-1 levels and ameliorates oxidative stress parameters induced by sepsis in an experimental rat model of sepsis.
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Lundberg OHM, Bergenzaun L, Rydén J, Rosenqvist M, Melander O, Chew MS. Adrenomedullin and endothelin-1 are associated with myocardial injury and death in septic shock patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:178. [PMID: 27282767 PMCID: PMC4899903 DOI: 10.1186/s13054-016-1361-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 05/27/2016] [Indexed: 01/28/2023]
Abstract
Background Adrenomedullin and endothelin-1 are hormones with opposing effects on the cardiovascular system. Adrenomedullin acts as a vasodilator and seems to be important for the initiation and continuation of the hyperdynamic circulatory response in sepsis. Endothelin-1 is a vasoconstrictor and has been linked to decreased cardiac performance. Few studies have studied the relationship between adrenomedullin and endothelin-1, and morbidity and mortality in septic shock patients. High-sensitivity troponin T (hsTNT) is normally used to diagnose acute cardiac injury but is also prognostic for outcome in intensive care. We investigated the relationship between mid-regional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1), and myocardial injury, measured using transthoracic echocardiography and hsTNT in septic shock patients. We were also interested in the development of different biomarkers throughout the ICU stay, and how early measurements were related to mortality. Further, we assessed if a positive biomarker panel, consisting of MR-proADM, CT-proET-1, and hsTNT changed the odds for mortality. Methods A cohort of 53 consecutive patients with septic shock had their levels of MR-proADM, CT-proET-1, hsTNT, and left ventricular systolic functions prospectively measured over 7 days. The relationship between day 1 levels of MR-proADM/CT-proET-1 and myocardial injury was studied. We also investigated the relationship between biomarkers and early (7-day) and later (28-day) mortality. Likelihood ratios, and pretest and posttest odds for mortality were calculated. Results Levels of MR-proADM and CT-proET-1 were significantly higher among patients with myocardial injury and were correlated with left ventricular systolic dysfunction. MR-proADM and hsTNT were significantly higher among 7-day and 28-day non-survivors. CT-proET-1 was also significantly higher among 28-day but not 7-day non-survivors. A positive biomarker panel consisting of the three biomarkers increased the odds for mortality 13-fold to 20-fold. Conclusions MR-proADM and CT-proET-1 are associated with myocardial injury. A biomarker panel combining MR-proADM, CT-proET-1, and hsTNT increases the odds ratio for death, and may improve currently available scoring systems in critical care.
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Affiliation(s)
- Oscar H M Lundberg
- Department of Intensive- and perioperative care, Skåne University Hospital Malmö, Inga Marie Nilssons gata 47, S-205 02, Malmö, Sweden.
| | - Lill Bergenzaun
- Department of Intensive- and perioperative care, Skåne University Hospital Malmö, Inga Marie Nilssons gata 47, S-205 02, Malmö, Sweden
| | - Jörgen Rydén
- Department of Intensive- and perioperative care, Skåne University Hospital Malmö, Inga Marie Nilssons gata 47, S-205 02, Malmö, Sweden
| | - Mari Rosenqvist
- Department of Infectious diseases, Skåne University Hospital Malmö, Ruth Lundskogs gata 3, S-205 02, Malmö, Sweden
| | - Olle Melander
- Department of Internal medicine, Skåne University Hospital Malmö, 205 02, Malmö, Sweden.,Lund University Institute of Clinical Sciences, Malmö, Sweden
| | - Michelle S Chew
- Lund University Institute of Clinical Sciences, Malmö, Sweden.,Department of Anesthesiology and Intensive Care, Linköping University, S-58185, Linköping, Sweden.,Department of Medical and Health Sciences, Linköping University, S-58185, Linköping, Sweden
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Nußbaum BL, McCook O, Hartmann C, Matallo J, Wepler M, Antonucci E, Kalbitz M, Huber-Lang M, Georgieff M, Calzia E, Radermacher P, Hafner S. Left ventricular function during porcine-resuscitated septic shock with pre-existing atherosclerosis. Intensive Care Med Exp 2016; 4:14. [PMID: 27271248 PMCID: PMC4894859 DOI: 10.1186/s40635-016-0089-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/31/2016] [Indexed: 02/07/2023] Open
Abstract
Background Reversible, depressed cardiac function is frequently encountered during septic shock and commonly called septic cardiomyopathy. Previous studies demonstrated reduced ejection fraction and left ventricular dilatation in both humans and animal models. However, the majority of the studies in humans excluded pre-existing cardiac disease and animal studies were performed on healthy specimen and/or without vasopressor support during sepsis. In order to more closely mimic the actual patients’ conditions on intensive care units and to assess the influence of both cardiac comorbidity and vasopressor support on septic cardiomyopathy, we evaluated the left ventricular function in a porcine model of resuscitated septic shock with pre-existing atherosclerosis. Methods Hypercholesterolaemic, atherosclerotic pigs due to homozygous low-density lipoprotein receptor mutation and high-fat diet were anaesthetised and surgically instrumented. Faecal peritonitis was induced by inoculation of autologous faeces into the peritoneal cavity in n = 8 animals; n = 5 pigs underwent sham procedure. Sepsis resuscitation included administration of fluids and noradrenaline. Left ventricular function was analysed via pressure-conductance catheters before, 12 and 24 h after the induction of sepsis. Results The main findings were impaired ventricular dilatation (no significant change in the left ventricular end-diastolic volume) and unchanged ejection fraction in septic pigs with pre-existing atherosclerosis. The relaxation time constant τ decreased while dp/dtmax increased. Cardiac nitrotyrosine formation increased while expression of the endogenous hydrogen sulphide (H2S)-producing enzyme cystathionine γ-lyase (CSE) decreased. Conclusions The data of the present study are in conflict with previously published data from healthy animal models, most likely as a result of ongoing resuscitation including noradrenaline treatment or intrinsic pathophysiologic processes of the pre-existing atherosclerosis. Moreover, increased nitrotyrosine formation and decreased expression of CSE suggest the implication of augmented oxidative/nitrosative stress and/or reduced bioavailability of nitric oxide as well as diminished endogenous H2S release in the pathophysiology of septic cardiomyopathy. Electronic supplementary material The online version of this article (doi:10.1186/s40635-016-0089-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Benedikt L Nußbaum
- Klinik für Anästhesiologie, Universitätsklinik Ulm, Ulm, Germany. .,Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany.
| | - Oscar McCook
- Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Clair Hartmann
- Klinik für Anästhesiologie, Universitätsklinik Ulm, Ulm, Germany.,Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - José Matallo
- Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Martin Wepler
- Klinik für Anästhesiologie, Universitätsklinik Ulm, Ulm, Germany.,Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Elena Antonucci
- Department of Surgical Sciences and Integrated Diagnostics, IRCCS San Martino IST, University of Genova, Genova, Italy
| | - Miriam Kalbitz
- Klinik für Unfall-, Hand-, Plastische- und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm, Germany
| | - Markus Huber-Lang
- Klinik für Unfall-, Hand-, Plastische- und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm, Germany
| | | | - Enrico Calzia
- Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Peter Radermacher
- Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Sebastian Hafner
- Klinik für Anästhesiologie, Universitätsklinik Ulm, Ulm, Germany.,Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinik Ulm, Helmholtzstraße 8/1, 89081, Ulm, Germany
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Value of caffeic acid phenethyl ester pretreatment in experimental sepsis model in rats. Mediators Inflamm 2015; 2015:810948. [PMID: 25948886 PMCID: PMC4408743 DOI: 10.1155/2015/810948] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/19/2015] [Accepted: 03/21/2015] [Indexed: 12/17/2022] Open
Abstract
Background and Aim. The aim of this study was to determine the actions of caffeic acid phenethyl ester (CAPE) on the changes of endothelin-1 (ET-1) level, tumor necrosis factor- (TNF-) alpha, and oxidative stress parameters such as superoxide dismutase (SOD) activities and malondialdehyde (MDA) levels in experimental sepsis model in rats. Materials and Methods. Twenty-four rats were randomly divided into three experimental groups: sham (group 1), sepsis (group 2), and sepsis + CAPE (group 3), n = 8 each. CAPE was administered (10 µmol/kg) intraperitoneally to group 3 before sepsis induction. Serum ET-1, serum TNF-alpha, tissue SOD activity, and tissue MDA levels were measured in all groups. Results. Pretreatment with CAPE decreased ET-1, TNF-alpha, and MDA levels in sepsis induced rats. Additionally SOD activities were higher in rats pretreated with CAPE after sepsis induction. Conclusion. Our results demonstrate that CAPE may have a beneficial effect on ET and TNF-alpha levels and oxidative stress parameters induced by sepsis in experimental rat models. Therefore treatment with CAPE can be used to avoid devastating effects of sepsis.
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Toney BM, Fisher AJ, Albrecht M, Lockett AD, Presson RG, Petrache I, Lahm T. Selective endothelin-A receptor blockade attenuates endotoxin-induced pulmonary hypertension and pulmonary vascular dysfunction. Pulm Circ 2014; 4:300-10. [PMID: 25006449 DOI: 10.1086/675993] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 01/16/2014] [Indexed: 01/07/2023] Open
Abstract
Endothelin-1 is a potent mediator of sepsis-induced pulmonary hypertension (PH). The pulmonary vascular effects of selective blockade of endothelin receptor subtype A (ETAR) during endotoxemia remain unknown. We hypothesized that selective ETAR antagonism attenuates endotoxin-induced PH and improves pulmonary artery (PA) vasoreactivity. Adult male Sprague-Dawley rats (250-450 g) received lipopolysaccharide (LPS; Salmonella typhimurium; 20 mg/kg intraperitoneally) or vehicle 6 hours before hemodynamic assessment and tissue harvest. The selective ETAR antagonist sitaxsentan (10 or 20 mg/kg) or vehicle was injected intravenously 3 hours after receipt of LPS. Right ventricular systolic pressure, mean arterial pressure (MAP), cardiac output (CO), oxygenation (P/F ratio), and serum bicarbonate were measured. Bronchoalveolar lavage (BAL) cell differential and lung wet-to-dry ratios were obtained. Endothelium-dependent and endothelium-independent vasorelaxations were determined in isolated PA rings. PA interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α), and inducible nitric oxide synthase (iNOS) messenger RNA (mRNA) were measured. LPS caused PH, decreased MAP, CO, and serum bicarbonate, and increased PA IL-1β, IL-6, TNF-α, and iNOS mRNA. Sitaxsentan attenuated sepsis-induced PH and increased MAP. The P/F ratio, CO, serum bicarbonate, and BAL neutrophilia were not affected by sitaxsentan. In isolated PA rings, while not affecting phenylephrine-induced vasocontraction or endothelium-dependent relaxation, sitaxsentan dose-dependently attenuated LPS-induced alterations in endothelium-independent relaxation. PA cytokine mRNA levels were not significantly attenuated by ETAR blockade. We conclude that ETAR blockade attenuates endotoxin-induced alterations in systemic and PA pressures without negatively affecting oxygenation. This protective effect appears to be mediated not by attenuation of sepsis-induced cardiac dysfunction, acidosis, or alveolar inflammation but rather by improved endothelium-independent vasorelaxation.
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Affiliation(s)
- Brent M Toney
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Amanda J Fisher
- Department of Anesthesiology, Indiana University, Indianapolis, Indiana, USA
| | - Marjorie Albrecht
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Angelia D Lockett
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Robert G Presson
- Department of Anesthesiology, Indiana University, Indianapolis, Indiana, USA ; Center for Immunobiology, Indiana University, Indianapolis, Indiana, USA
| | - Irina Petrache
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University, Indianapolis, Indiana, USA ; Center for Immunobiology, Indiana University, Indianapolis, Indiana, USA ; Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
| | - Tim Lahm
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University, Indianapolis, Indiana, USA ; Center for Immunobiology, Indiana University, Indianapolis, Indiana, USA ; Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
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Inflammatory signalling associated with brain dead organ donation: from brain injury to brain stem death and posttransplant ischaemia reperfusion injury. J Transplant 2013; 2013:521369. [PMID: 23691272 PMCID: PMC3649190 DOI: 10.1155/2013/521369] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 01/19/2013] [Accepted: 01/22/2013] [Indexed: 01/26/2023] Open
Abstract
Brain death is associated with dramatic and serious pathophysiologic changes that adversely affect both the quantity and quality of organs available for transplant. To fully optimise the donor pool necessitates a more complete understanding of the underlying pathophysiology of organ dysfunction associated with transplantation. These injurious processes are initially triggered by catastrophic brain injury and are further enhanced during both brain death and graft transplantation. The activated inflammatory systems then contribute to graft dysfunction in the recipient. Inflammatory mediators drive this process in concert with the innate and adaptive immune systems. Activation of deleterious immunological pathways in organ grafts occurs, priming them for further inflammation after engraftment. Finally, posttransplantation ischaemia reperfusion injury leads to further generation of inflammatory mediators and consequent activation of the recipient's immune system. Ongoing research has identified key mediators that contribute to the inflammatory milieu inherent in brain dead organ donation. This has seen the development of novel therapies that directly target the inflammatory cascade.
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Abstract
The vasoconstrictive and proinflammatory peptide endothelin 1 (ET-1) is highly involved in the pathogenesis of sepsis and associated lung injury. Systemic administration of ET-receptor antagonists has been beneficial in experimental pulmonary hypertension. We wanted to study the effects of inhaled tezosentan, a dual endothelin-receptor antagonist on endotoxin-induced pulmonary hypertension, deterioration of gas exchange, and edema formation. After 2 h of endotoxemia, 28 anesthetized, mechanically ventilated pigs were randomized to either inhaled tezosentan 0.5 mg x kg (TEZO(0.5), n = 7), 0.05 mg x kg (TEZO(0.05), n = 7), intravenous 0.5 mg x kg (TEZO(iv), n = 7), or control (n = 7). Cardiopulmonary hemodynamics and gas-exchange parameters were recorded as well as extravascular lung water and pulmonary capillary pressure. In addition, plasma levels of tezosentan and ET-1 were analyzed. The protocol lasted for 5 h. Endotoxin-induced pulmonary hypertension (mean pulmonary artery pressure) was efficiently reduced by all treatments (TEZO(0.5) 24 +/- 2, TEZO(0.05) 27 +/- 2, TEZO(iv) 26 +/- 1, and control 37 +/- 2 mmHg at 4 h). TEZO(0.5) and TEZO(iv) also reduced pulmonary capillary pressure. All treatments led to a modest reduction in extravascular lung water, whereas no effects were noted on oxygenation or systemic circulation. Despite similar effects on pulmonary hypertension systemic treatment resulted in significantly higher plasma levels of ET-1 (twofold) and tezosentan (10- to 100-fold). Inhalation of the dual ET-receptor antagonist tezosentan was feasible and efficiently counteracted endotoxin-induced pulmonary hypertension. These effects were obtained with only minor systemic uptake of tezosentan and without affecting circulating levels of plasma ET-1 as compared with intravenous administration.
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A'roch R, Steendijk P, Oldner A, Weitzberg E, Konrad D, Johansson G, Haney M. Left ventricular mechanical dyssynchrony is load independent at rest and during endotoxaemia in a porcine model. Acta Physiol (Oxf) 2009; 196:375-83. [PMID: 19302073 DOI: 10.1111/j.1748-1716.2009.01962.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIM In diseased or injured states, the left ventricle displays higher degrees of mechanical dyssynchrony. We aimed at assessing mechanical dyssynchrony ranges in health related to variation in load as well as during acute endotoxin-induced ventricular injury. METHODS In 16 juvenile anaesthetized pigs, a five-segment conductance catheter was placed in the left ventricle as well as a balloon-tipped catheter in the inferior vena cava. Mechanical dyssynchrony during systole, including dyssynchrony time in per cent during systole and internal flow fraction during systole, were measured at rest and during controlled pre-load reduction sequences, as well as during 3 h of endotoxin infusion (0.25 microg kg(-)1 h(-1)). RESULTS Systolic dyssynchrony and internal flow fraction did not change during the course of acute beat-to-beat pre-load alteration. Endotoxin-produced acute pulmonary hypertension by left ventricular dyssynchrony measures was not changed during the early peak of pulmonary hypertension. Endotoxin ventricular injury led to progressive increases in systolic mechanical segmental dyssynchrony (7.9 +/- 1.2-13.0 +/- 1.3%) and ventricular systolic internal flow fraction (7.1 +/- 2.4-16.6 +/- 2.8%), respectively for baseline and then at hour 3. There was no localization of dyssynchrony changes to segment or region in the ventricular long axis during endotoxin infusion. CONCLUSION These results suggest that systolic mechanical dyssynchrony measures may be load independent in health and during acute global ventricular injury by endotoxin. More study is needed to validate ranges in health and disease for parameters of mechanical dyssynchrony.
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Affiliation(s)
- R A'roch
- Anesthesia and Intensive Care Medicine, University Hospital of Umeå, Umeå, Sweden.
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Aberg AM, Abrahamsson P, Johansson G, Haney M, Winsö O, Larsson JE. Does carbon monoxide treatment alter cytokine levels after endotoxin infusion in pigs? A randomized controlled study. JOURNAL OF INFLAMMATION-LONDON 2008; 5:13. [PMID: 18687112 PMCID: PMC2518540 DOI: 10.1186/1476-9255-5-13] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Accepted: 08/07/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND Carbon monoxide (CO) has recently been suggested to have anti-inflammatory properties, but data seem to be contradictory and species-specific. Thus, in studies on macrophages and mice, pretreatment with CO attenuated the inflammatory response after endotoxin exposure. On the other hand, human studies showed no effect of CO on the inflammatory response. Anti-inflammatory efficacy of CO has been shown at concentrations above 10% carboxyhaemoglobin. This study was undertaken to elucidate the possible anti-inflammatory effects of CO at lower CO concentrations. METHODS Effects of CO administration on cytokine (TNF-alpha, IL-6, IL-1beta and IL-10) release were investigated in a porcine model in which a systemic inflammatory response syndrome was induced by endotoxin infusion. Endotoxin was infused in 20 anaesthetized and normoventilated pigs. Ten animals were targeted with inhaled CO to maintain 5% COHb, and 10 animals were controls. RESULTS In the control group, mean pulmonary artery pressure increased from a baseline value of 17 mmHg (mean, n = 10) to 42 mmHg (mean, n = 10) following 1 hour of endotoxin infusion. Similar mean pulmonary artery pressure values were found in animals exposed to carbon monoxide. Plasma levels of all of the measured cytokines increased in response to the endotoxin infusion. The largest increase was observed in TNF-alpha, which peaked after 1.5 hours at 9398 pg/ml in the control group and at 13395 pg/ml in the carbon monoxide-exposed group. A similar peak was found for IL-10 while the IL-6 concentration was maximal after 2.5 hours. IL-1beta concentrations increased continuously during the experiment. There were no significant differences between carbon monoxide-exposed animals and controls in any of the measured cytokines. CONCLUSION Our conclusion is that 5% COHb does not modify the cytokine response following endotoxin infusion in pigs.
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Affiliation(s)
- Anna-Maja Aberg
- Division of Anaesthesiology and Intensive Care Medicine, Department of Surgical and Perioperative Sciences, Umeå University Hospital, Umeå, Sweden.
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Lester SJ, Tajik AJ, Nishimura RA, Oh JK, Khandheria BK, Seward JB. Unlocking the Mysteries of Diastolic Function. J Am Coll Cardiol 2008; 51:679-89. [PMID: 18279730 DOI: 10.1016/j.jacc.2007.09.061] [Citation(s) in RCA: 268] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2007] [Revised: 09/20/2007] [Accepted: 09/24/2007] [Indexed: 01/19/2023]
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Andersson A, Fenhammar J, Frithiof R, Weitzberg E, Sollevi A, Hjelmqvist H. Mixed endothelin receptor antagonism with tezosentan improves intestinal microcirculation in endotoxemic shock. J Surg Res 2008; 149:138-47. [PMID: 18639249 DOI: 10.1016/j.jss.2007.12.751] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 11/12/2007] [Accepted: 12/06/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND Microcirculatory dysfunction is a common feature of sepsis. The potent vasoconstrictor endothelin (ET) is released in sepsis and endotoxemia, potentially contributing to sepsis-induced microcirculatory failure. In this study we tested the hypothesis that mixed ET receptor antagonism with tezosentan would improve splanchnic microcirculatory blood flow in acute porcine endotoxemia. MATERIALS AND METHODS Sixteen anesthetized and mechanically ventilated pigs received an infusion of endotoxin for 300 min. After 120 min eight pigs received a bolus dose of tezosentan 1 mg/kg followed by an infusion of tezosentan of 1 mg/kg/h throughout the experiment. Eight pigs served as endotoxin controls. Laser Doppler flowmetry was used to measure microcirculatory blood flow in the liver and in the ileal and colon mucosa. PCO(2) in the ileal mucosa was measured by air tonometry and portal vein flow by an ultrasonic flow probe. RESULTS Endotoxin administration induced a state of shock with impaired splanchnic microcirculatory blood flow. Microcirculation in the mucosa of the colon and ileum and mucosal-arterial PCO(2) gap were improved by tezosentan. Portal vein flow was increased, but hepatic microcirculatory blood flow was not significantly improved. Tezosentan preserved cardiac index and decreased pulmonary capillary wedge pressure compared to controls, without causing any differences in the heart rate or mean arterial blood pressure response. Tezosentan also distinctly improved pH and arterial lactate values. CONCLUSIONS The findings of this study indicate that ET is involved in the microcirculatory dysfunction seen in the ileal and colon mucosa in early endotoxemia. Moreover, this detrimental effect was counteracted by i.v. administration of the mixed ET receptor antagonist tezosentan.
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Affiliation(s)
- Andreas Andersson
- Department of Anaesthesiology & Intensive Care, Karolinska University Hospital Huddinge, Sweden.
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