Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Schwarzl, M; Seiler, S; Wallner, M; von, Lewinski, D; Huber, S; Maechler, H; Steendijk, P; Zelzer, S; Truschnig-Wilders, M; Obermayer-Pietsch, B; Lueger, A; Pieske, BM; Post, H.
Mild hypothermia attenuates circulatory and pulmonary dysfunction during experimental endotoxemia.
Crit Care Med. 2013; 41(12):e401-10
Doi: 10.1097/CCM.0b013e31829791da
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Post Heiner
- Schwarzl Michael
- Co-authors Med Uni Graz
- Huber Stefan
- Lueger Andreas
- Mächler Heinrich
- Obermayer-Pietsch Barbara
- Pieske Burkert Mathias
- Truschnig-Wilders Martini
- von Lewinski Dirk
- Wallner Markus
- Zelzer Sieglinde
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- Abstract:
- OBJECTIVE: We tested whether mild hypothermia impacts on circulatory and respiratory dysfunction during experimental endotoxemia. DESIGN: Randomized controlled prospective experimental study. SETTING: Large animal facility, Medical University of Graz, Austria. SUBJECTS: Thirteen anesthetized and mechanically ventilated pigs. INTERVENTIONS: Lipopolysaccharide was administered for 4 hours. With the beginning of lipopolysaccharide infusion, animals were assigned to either normothermia (38°C, n = 7) or mild hypothermia (33°C, n = 6, intravascular cooling) and followed for 8 hours in total. MEASUREMENTS AND MAIN RESULTS: At the end of the protocol, cardiac output was lower in mild hypothermia than in normothermia (4.5 ± 0.4 L/min vs 6.6 ± 0.4 L/min, p < 0.05), but systemic vascular resistance (885 ± 77 dyn·s/cm vs 531 ± 29 dyn·s/cm, p < 0.05) and (Equation is included in full-text article.)(77% ± 6% vs 54% ± 3%, p < 0.05) were higher. Indices of left ventricular contractility in vivo were not different between groups. The high-frequency band in spectral analysis of heart rate variability indicated a better preserved vagal autonomic modulation of sinuatrial node activity in mild hypothermia versus normothermia (87 ± 5 vs 47 ± 5, normalized units, p < 0.05). Plasma norepinephrine levels were elevated compared with baseline in normothermia (2.13 ± 0.27 log pg/mL vs 0.27 ± 0.17 log pg/mL, p < 0.05) but not in mild hypothermia (1.02 ± 0.31 vs 0.55 ± 0.26, p = not significant). At 38°C in vitro, left ventricular muscle strips isolated from the mild hypothermia group had a higher force response to isoproterenol. SaO2 (100% ± 0% vs 92% ± 3%, p < 0.05) and the oxygenation index (PO2/FIO2, 386 ± 52 mm Hg vs 132 ± 32 mm Hg, p < 0.05) were substantially higher in mild hypothermia versus normothermia. Plasma cytokine levels were not consistently different between groups (interleukin 10) or higher (tumor necrosis factor-α and interleukin 6 and 8) during mild hypothermia versus normothermia. CONCLUSION: The induction of mild hypothermia attenuates cardiac and respiratory dysfunction and counteracts sympathetic activation during experimental endotoxemia. This was not associated with lower plasma cytokine levels, indicating a reduction of cytokine responsiveness by mild hypothermia.
- Find related publications in this database (using NLM MeSH Indexing)
- Animals - administration & dosage
- Cardiac Output - administration & dosage
- Cardiotonic Agents - pharmacology
- Cytokines - blood
- Endotoxemia - blood, chemically induced, physiopathology, therapy
- Heart Rate - administration & dosage
- Heart Ventricles - physiopathology
- Hypothermia, Induced - administration & dosage
- Isoproterenol - pharmacology
- Lipopolysaccharides - administration & dosage
- Myocardial Contraction - drug effects
- Norepinephrine - blood
- Oxygen - blood
- Random Allocation - administration & dosage
- Swine - administration & dosage
- Vascular Resistance - administration & dosage
- Find related publications in this database (Keywords)
- autonomic function
- endotoxin
- lipopolysaccharide
- myocardial function
- pulmonary function
- sepsis