Norepinephrine and N ω-Monomethyl-l-arginine in Porcine Septic Shock

摘要: We compared the effects of norepinephrine (NOR; n = 11) and nonselective nitric oxide synthase inhibitor N ω-monomethyl-l-arginine (l-NMMA; on hepatic blood flow (Q˙ liv), O2 exchange, energy metabolism over 24 h hyperdynamic, normotensive porcine endotoxic shock. Endotoxin (ETX; 8) caused a continuous fall in mean arterial pressure (MAP) despite sustained 50% increase cardiac output (Q˙) achieved by adequate fluid resuscitation. NOR maintained MAP at preshock levels owing to further rise Q˙, while comparable hemodynamic stabilization during l-NMMA infusion resulted from systemic vasoconstriction, increasing vascular resistance (SVR) about 30% shock level after 6 treatment concomitant with reduction Q˙ values. Whereas also increased liv and, hence, delivery (hDo 2), but did not affect uptake (hVo influenced neither nor hDo 2 hVo 2. Mean capillary hemoglobin saturation (HbScO2 ...