Journal article
The effects of norepinephrine on gas exchange and regional blood flows after massive bead embolization
Journal of critical care, Vol.5(3), pp.180-185
1990
DOI: 10.1016/0883-9441(90)90039-C
Abstract
The effects of norepinephrine (NE) on gas exchange and regional blood flows (RBFs) during resuscitation of massive pulmonary embolism (PE) were studied in 10 anesthetized mongrel dogs. Acute PE was induced by infusing 2 to 3 g of polystyrene beads (100 to 130 μm) into the right atrium so that the cardiac output (Qt) was reduced to approximately half the baseline value. Prior to and after PE, the V̇
A/Q̇ distribution was estimated by the multiple inert gas elimination technique. The animals in group 1 (n = 6) were immediately resuscitated after PE by infusion of NE for 40 minutes in quantities sufficient to return Qt to pre-PE levels. Those in group 2 (n = 4) did not receive any intervention for the first 40 minutes after PE, but were similarly resuscitated by NE in the subsequent 20 minutes. Regional blood flows were marked by three radioactive 15-μm microspheres: prior to PE, immediately after PE, and 20 minutes after PE in both groups. The gas exchange data show that the RBF pattern after PE had a significant redistribution of flow to the upper lung zones. Norepinephrine infusion increased RBFs proportionally in all zones after PE without changing the pattern of flow already established after PE. The distribution of perfusion to shunt and V̇
A/Q̇ less than 0.1 and the distribution of ventilation to dead space and V̇
A/Q̇ greater than 10 increased immediately after PE and remained comparable after NE infusion. Thus, while NE infusion significantly increased systemic oxygen delivery it had minor effect on gas exchange heterogeneity following embolism.
Details
- Title: Subtitle
- The effects of norepinephrine on gas exchange and regional blood flows after massive bead embolization
- Creators
- John Y. Tsang - University of WashingtonMichael M. Graham - University of WashingtonH. Thomas Robertson - UBC Pulmonary Research Laboratory, St Paul's Hospital, Vancouver, BC, Canada
- Resource Type
- Journal article
- Publication Details
- Journal of critical care, Vol.5(3), pp.180-185
- Publisher
- Elsevier Inc
- DOI
- 10.1016/0883-9441(90)90039-C
- ISSN
- 0883-9441
- eISSN
- 1557-8615
- Language
- English
- Date published
- 1990
- Academic Unit
- Radiology; Radiation Oncology
- Record Identifier
- 9984312967502771
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