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Arginine vasopressin does not alter mucosal tissue oxygen tension and oxygen supply in an acute endotoxemic pig model
Authors:Hans Knotzer  Stephan Maier  Martin W. Dünser  Walter R. Hasibeder  Hans Hausdorfer  Julia Brandner  Christian Torgersen  Hanno Ulmer  Barbara Friesenecker  Claudia Iannetti  Werner Pajk
Affiliation:(1) Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria;(2) Department of Anesthesiology and Critical Care Medicine, Krankenhaus der Barmherzigen Schwestern Ried, Ried i. I., Austria;(3) Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Innsbruck, Austria;(4) Department for Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria;(5) Department of General Surgery, Innsbruck Medical University, Innsbruck, Austria
Abstract:Objective To determine the effects of increasing dosages of continuously infused arginine-vasopressin (AVP) on mucosal tissue oxygen tension and oxygen supply in an auto-perfused, innervated jejunal segment in an acute endotoxic porcine model.Design Prospective, randomized, experimental study.Setting University hospital animal research laboratory.Interventions Jejunal mucosal tissue PO2 was measured employing two Clark-type surface oxygen electrodes. Oxygen saturation of jejunal microvascular hemoglobin was determined by tissue reflectance spectrophotometry. Systemic hemodynamic variables, mesenteric-venous and systemic acid base and blood gas variables and lactate measurements were recorded. Measurements were performed at baseline, after E. coli lipopolysaccharide (LPS) administration and at 20 min intervals during incremental AVP infusion ( n =8; 0.014, 0.029, 0.057, 0.114 and 0.229 IU kg-1 h-1, respectively) or infusion of saline ( n =8).Measurements and results LPS infusion leads to a significant ( P <0.05) decrease of mucosal tissue oxygen tension (PO2muc, 24±3 to 12±2 mmHg) and microvascular hemoglobin oxygen saturation (HbO2, 38±4 to 21±4%). Mesenteric venous lactate level increased (2.4±0.3 to 4.7±1.7 mmol l-1), while mesenteric venous pH decreased (7.38±0.02 to 7.26±0.12), indicating tissue hypoxia. AVP significantly increased mean arterial pressure (MAP, 81±15 to 97±17 at 0.057 IU kg-1 h-1). No differences in jejunal mucosal oxygenation occurred between study groups at any dosage during the experimental protocol.Conclusion AVP administration did not further compromise mucosal tissue oxygen tension and oxygen supply in the acute phase of endotoxic pigs.This article refers to the editorial
Keywords:Arginine-vasopressin  Endotoxemia  Tissue oxygen tension  Reflectance spectrophotometry  Jejunum
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