• Shock · Aug 2016

    Beneficial Effects of Norepinephrine Alone on Cardiovascular Function and Tissue Oxygenation in a Pig Model of Cardiogenic Shock.

    • Alexandra Beurton, Nicolas Ducrocq, Thomas Auchet, Frédérique Joineau-Groubatch, Aude Falanga, Antoine Kimmoun, Nicolas Girerd, Renaud Fay, Fabrice Vanhuyse, Nguyen Tran, and Bruno Levy.
    • *INSERM U1116, Groupe Choc, Faculté de Médecine, Nancy, France †CHU Nancy, Service de Réanimation Médicale Brabois, Pole Cardiovasculaire et Réanimation Médicale, Hôpital Brabois, Nancy, France ‡Université de Lorraine, Nancy, France §School of Surgery Nancy-Lorraine, Faculté de Médecine, Nancy, France ||INSERM, Centre d'Investigations Cliniques-9501 and CHU de Nancy, Nancy, France ¶Service de chirurgie cardiaque et transplantations, Pole Cardiovasculaire et Réanimation Médicale, Hôpital Brabois, Nancy, France.
    • Shock. 2016 Aug 1; 46 (2): 214-8.

    IntroductionThe present study was developed to investigate the effects of norepinephrine alone on hemodynamics and intrinsic cardiac function in a pig model of cardiogenic shock mimicking the clinical setting.MethodsCardiogenic shock was induced by 1-h ligation of the left anterior descending (LAD) artery followed by reperfusion. Pigs were monitored with a Swan-Ganz catheter, a transpulmonary thermodilution catheter, and a conductance catheter placed in the left ventricle for pressure-loop measurements. Measurements were performed before LAD occlusion, 1 h after LAD occlusion, and 4 h after myocardial reperfusion.ResultsMyocardial infarction and reperfusion was followed by cardiogenic shock characterized by a significant increase in heart rate and significant decreases in mean arterial pressure (MAP), mixed venous oxygen saturation (SVO2), left ventricular end-diastolic pressure (LVEDP), prerecruitable stroke work (PRSW), and cardiac power index (CPI). Lactate levels were significantly increased. The systemic vascular resistance index (SVRI) and global end-diastolic volume index (GEDVI) remained unchanged. When compared with the control group (n = 6), norepinephrine infusion (n = 6) was associated with no changes in heart rate, a significant increase in MAP, SVO2, left ventricular ejection fraction, pressure development during isovolumic contraction, SVRI, and CPI and a decrease in lactate level. Cardiac index tended to increase (P = 0.059), whereas PRSW did not change in the norepinephrine group. LVEDP and GEDVI remained unchanged.ConclusionsNorepinephrine alone is able to improve hemodynamics, cardiac function, and tissue oxygenation in a pig model of ischemic cardiogenic shock.

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