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Báo cáo y học: "Role of selective V2-receptor-antagonism in septic shock: a randomized, controlled, experimental study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Role of selective V2-receptor-antagonism in septic shock: a randomized, controlled, experimental study. | Rehberg et al. Critical Care 2010 14 R200 http ccforum.eom content 14 6 R200 c CRITICAL CARE RESEARCH Open Access Role of selective V2-receptor-antagonism in septic shock a randomized controlled experimental study 1 1 1 2 3 4 Sebastian Rehberg Christian Ertmer Matthias Lange Andrea Morelli Elbert Whorton Martin Dunser 1 1 1 1 5 1 Anne-Katrin Strohhacker Erik Lipke Tim G Kampmeier Hugo Van Aken Daniel L Traber Martin Westphal Abstract Introduction V2-receptor V2R stimulation potentially aggravates sepsis-induced vasodilation fluid accumulation and microvascular thrombosis. Therefore the present study was performed to determine the effects of a first-line therapy with the selective V2R-antagonist Propionyl1-D-Tyr Et 2-Val4-Abu6-Arg8 9 -Vasopressin on cardiopulmonary hemodynamics and organ function vs. the mixed V1aR V2R-agonist arginine vasopressin AVP or placebo in an established ovine model of septic shock. Methods After the onset of septic shock chronically instrumented sheep were randomly assigned to receive first-line treatment with the selective V2R-antagonist 1 pg kg per hour AVP 0.05 pg kg per hour or normal saline placebo each n 7 . In all groups open-label norepinephrine was additionally titrated up to 1 pg kg per minute to maintain mean arterial pressure at 70 5 mmHg if necessary. Results Compared to AVP- and placebo-treated animals the selective V2R-antagonist stabilized cardiopulmonary hemodynamics mean arterial and pulmonary artery pressure cardiac index as effectively and increased intravascular volume as suggested by higher cardiac filling pressures. Furthermore left ventricular stroke work index was higher in the V2R-antagonist group than in the AVP group. Notably metabolic pH base excess lactate concentrations liver transaminases bilirubin and renal creatinine and blood urea nitrogen plasma levels urinary output creatinine clearance dysfunctions were attenuated by the V2R-antagonist when compared with AVP and placebo. The onset of septic shock was .