Splanchnic blood flow is greater in septic shock treated with norepinephrine than in severe sepsis

Title

Splanchnic blood flow is greater in septic shock treated with norepinephrine than in severe sepsis

Creator

MeierHellmann A; Specht M; Hannemann L; Hassel H; Bredle D L; Reinhart K

Publisher

Intensive Care Medicine

Date

1996
1996-12

Description

Objective: To assess global and splanchnic blood flow and oxygen transport in patients with sepsis with and without norepinephrine treatment. Design: Prospective, clinical study. Setting: University hospital intensive care unit. Patients: A convenience sample of 15 septic shock patients treated with norepinephrine and 13 patients with severe sepsis who did not receive norepinephrine. Measurements and main results: There were no differences between the two groups in global haemodynamics and oxygen transport. Splanchnic blood flow and oxygen delivery (splanchnic DO2 303 +/- 43 ml/min per m(2)) and consumption (splanchnic VO2 100 +/- 13 ml/min per m(2)) were much higher in the septic shock group compared with the severe sepsis group (splanchnic DO2 175 +/- 19 ml/min per m(2), splanchnic VO2 61 +/- 6 ml/min per m(2)). Gastric mucosal pH was subnormal in both groups (septic shock 7.29 +/- 0.02, severe sepsis 7.25 +/- 0.02) with no significant difference. No significant differences between groups were detected in lactate values. Conclusion: These data confirm a redistribution of blood flow to the splanchnic region in sepsis that is even more pronounced in patients with septic shock requiring norepinephrine. However, subnormal gastric mucosal pH suggested inadequate oxygenation in parts of the splanchnic region due to factors other than splanchnic hypoperfusion. Progress in this area will depend on techniques that address not only total splanchnic blood flow, but also inter-organ flow distribution, intra-organ distribution, and other microcirculatory or metabolic malfunctions.

Subject

sepsis; hypoxia; transport; General & Internal Medicine; metabolism; dopamine; septic shock; norepinephrine; failure; gut; oxygen consumption; endotoxemia; splanchnic oxygen delivery; splanchnic oxygen consumption; critically ill; extraction; splanchnic blood flow

Format

Journal Article or Conference Abstract Publication

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

1354-1359

Issue

12

Volume

22

Citation

MeierHellmann A; Specht M; Hannemann L; Hassel H; Bredle D L; Reinhart K, “Splanchnic blood flow is greater in septic shock treated with norepinephrine than in severe sepsis,” NEOMED Bibliography Database, accessed May 11, 2021, https://neomed.omeka.net/items/show/9093.

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