• Intensive care medicine · Dec 2002

    Randomized Controlled Trial Clinical Trial

    Norepinephrine and vital organ blood flow.

    • David Di Giantomasso, Clive N May, and Rinaldo Bellomo.
    • Department of Intensive Care, Austin and Repatriation Medical Centre, Heidelberg, Victoria 3084, Australia.
    • Intensive Care Med. 2002 Dec 1; 28 (12): 1804-9.

    ObjectiveTo test whether norepinephrine (NE) infusion at 0.4 microg kg(-1) min(-1) adversely affects regional blood flow in the normal mammalian circulation.Design And SettingRandomized cross-over experimental animal study in a university-affiliated physiology institute.SubjectsSix merino ewes.InterventionsStaged insertion of transit-time flow probes around the ascending aorta and circumflex coronary, superior mesenteric and left renal arteries. In conscious animals with chronically embedded flow probes randomization to either 6 h of placebo (saline) or drug (NE at 0.4 microg kg(-1) min(-1)).Measurements And ResultsCompared to placebo, NE significantly increased mean arterial pressure (84.4 vs. 103.8 mmHg), heart rate (61.0 vs. 74.6 bpm) and cardiac output (3.76 vs. 4.78 l/min). These changes were associated with an increase in coronary blood flow (24.2 vs. 37.4 ml/min) and renal blood flow (215.2 vs. 282.0 ml/min) but no change in mesenteric blood flow. The increase in renal and coronary blood flow was associated with an increase in regional conductance (regional vasodilatation), while mesenteric conductance fell (mesenteric vasoconstriction). Urine output (91+/-17 vs. 491+/-360 ml/h) and creatinine clearance (61+/-18 vs. 89+/-12 ml/min) increased during NE infusion.ConclusionsNE infusion does not induce vital organ ischaemia in the normal mammalian circulation. Furthermore, it results in a significant increase in coronary and renal blood flow with a concomitant improvement in urine output and creatinine clearance.

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