A prospective, randomized trial of intravenous hydroxocobalamin versus noradrenaline or saline for treatment of lipopolysaccharide-induced hypotension in a swine model

Autor:	Vikhyat S. Bebarta, David A. Tanen, Maria G Castaneda, Joseph K. Maddry, Normalynn Garrett, Susan M Boudreau, Patricia S. Dixon, Allyson A. Arana
Rok vydání:	2019
Předmět:	Lipopolysaccharides 0301 basic medicine Cardiac output Mean arterial pressure Swine Physiology medicine.medical_treatment Alpha (ethology) law.invention Sepsis Norepinephrine 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Hydroxocobalamin Physiology (medical) medicine Animals Saline Pharmacology business.industry Hemodynamics medicine.disease Shock Septic Disease Models Animal 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Anesthesia Vascular resistance Administration Intravenous Female Gases Saline Solution Hypotension business Biomarkers medicine.drug
Zdroj:	Clinical and Experimental Pharmacology and Physiology. 46:216-225
ISSN:	0305-1870
Popis:	Early, non-clinical studies support the use of hydroxocobalamin to treat sepsis-induced hypotension, but there is no translational, large animal model. The objective of this study was to compare survival in a sepsis model where large swine had endotoxaemia induced with lipopolysaccharide (LPS) and were treated with intravenous hydroxocobalamin (HOC), noradrenaline (NA), or saline. Thirty swine (45-55 kg) were anaesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. Hypotension, predefined as 50% of baseline, was induced with LPS. Animals then received HOC, NA, or saline and monitored for 3 hours. The main outcome was survival to the conclusion of the study. Using a power of 80% and an alpha of 0.05, 10 animals were used per group. Secondary outcomes included: mean arterial pressure (MAP), systemic vascular resistance (SVR) and cardiac output (CO) along with several markers of sepsis. No differences were detected between groups at baseline or after hypotension. The survival distributions of the three groups were significantly different with more HOC animals surviving (10/10) compared with NA (8/10) or Saline (5/10) (log-rank P
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::521331fe8166140327ead38f39ef4c2f https://doi.org/10.1111/1440-1681.13060 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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