Effect of noradrenaline and adrenaline on the microvascular hemoglobin oxygenation of the gastric mucosa under anesthesia with sevoflurane or propofol

L.A. Schwarte, Ingo Schwartges, P. Schober, A. Fournell, Thomas Scheeren, O. Picker

Research output: Contribution to conferenceAbstractAcademic

Abstract

Background:
Adequate gastrointestinal mucosa oxygenation appears important for the prevention and therapy of sepsis and multiorgan failure [1]. Adrenaline (ADR) and norepinephrine (NOR) become perioperative hemodynamic stabilization. However, the effects are unclear of ADR and NOR on the microvascular hemoglobin oxygenation of the gastric mucosa (μHbO2). Here, the effects of ADR and NOR could depend on the used anesthetic. We therefore examined the effects of ADR and NOR under sevoflurane (SEVO) or propofol (PROPO) anesthesia on the regional μHbO2 and the systemic O2 transport (DO2).


Material & Methods:
Chronically instrumented dogs (24 experiments, 27-35kg; approved by the Animal Protection Commission) were repeatedly anesthetized (randomized with SEVO or PROPO), ventilated, and were randomized to NOR or ADR (0 / 0.05 / 0.1 / 0.2 μg / kg / min). The μHbO2 were measured (spectrophotometry) and the DO2 [2]


Statistics:
Data are given as mean ± sem, ANOVA, Fisher PLSD; P <0.05.

Results:
Under SEVO, NOR significantly increased the μHbO2 from 55 ± 1 to 67 ± 2% and also the DO2 (from 12 ± 1 to 20 ± 2 ml / kg / min). In contrast to ADR could not increase the μHbO2 (57 ± 1 vs. 57 ± 2%), despite the more pronounced increase in DO2 (from 12 ± 1 to 27 ± 3 ml / kg / min). In contrast to these significant and contrasting effects under SEVO, was achieved under PROPO none of the catecholamines significantly alter the μHbO2: both ADR and NOR (in all dosages) stably maintained the μHbO2 at the initial level (ADR: 58 ± 2 vs. 58 ± 3%; NOR: 56 ± 2 vs. 57 ± 3%). However, as under SEVO, doubled ADR also under PROPO the DO2 (from 16 ± 1 to 33 ± 2 ml / kg / min), whereas again, NOR changed the DO2 only slightly (from 16 ± 1 to 19 ± 1 ml / kg / min).

Conclusions: 
The regional effects (μHbO2) of NOR and ADR are depending on the anesthetic used, i. SEVO or PROPO. Here increases NOR, but not ADR, the μHbO2 under SEVO, where both are catecholamines do not increase the μHbO2 under PROPO. If our data can be transferred to the clinical situation, NOR appears (depending on the anesthetic, for example), gastric mucosal oxygenation to maintain or even to increase.


References: 
[1] LA Schwarte, M Stevens, C Ince. JL Vincent (ed.) Yearbook of Intensive Careand Emergency Medicine 2006; 627-40
[2] LA Schwarte, O Picker, SR Bornstein et al. Crit Care Med. 2005; 33: 135-42 
Translated title of the contributionEffect of noradrenaline and adrenaline on the microvascular hemoglobin oxygenation of the gastric mucosa under anesthesia with sevoflurane or propofol
Original languageGerman
Number of pages1
Publication statusPublished - 28-Apr-2008
EventJahrestagung der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin DAC 2008 - Nürnberg, Germany
Duration: 26-Apr-200829-Apr-2008

Conference

ConferenceJahrestagung der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin DAC 2008
Abbreviated titleDAC 2008
CountryGermany
CityNürnberg
Period26/04/200829/04/2008

Cite this