Benefits of ethyl gallate versus norepinephrine in the treatment of cardiovascular collapse in Pseudomonas aeruginosa septic shock in dogs*
| Autor: | Hans Jacobs, Jose Gotes, Zhao-Qin Cheng, Steven N. Mink, Krika Kasian |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
endocrine system
Shock Cardiogenic Ethyl gallate Critical Care and Intensive Care Medicine medicine.disease_cause Risk Assessment Drug Administration Schedule Norepinephrine (medication) Norepinephrine Random Allocation chemistry.chemical_compound Dogs Gallic Acid medicine Animals Pseudomonas Infections Collapse (medical) Analysis of Variance Dose-Response Relationship Drug Pseudomonas aeruginosa business.industry Septic shock medicine.disease Shock Septic Survival Rate Disease Models Animal Treatment Outcome chemistry Anesthesia medicine.symptom business Perfusion hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Critical Care Medicine. 40:560-572 |
| ISSN: | 0090-3493 |
| Popis: | Vasopressor therapy is required in septic shock to maintain tissue perfusion in the face of hypotension. Unfortunately, there are significant side effects of current vasopressors, and newer agents need to be developed. We recently discovered that ethyl gallate, a nonflavonoid phenolic antioxidant found in food substances, could reverse low mean arterial pressure found in an experimental model of septic shock due to inhibition of hydrogen peroxide signaling. In the present study, we compared the hemodynamic and biochemical effects of ethyl gallate vs. those of the commonly used vasopressor, norepinephrine, in a bacteremic canine model of Pseudomonas aeruginosa sepsis in two protocols.We performed these studies in anesthetized and mechanically ventilated dogs. In the early treatment protocol, we infused P. aeruginosa until mean arterial pressure first decreased to ∼60 mm Hg (about 2-3 hrs), after which we stopped the infusion and randomly administered ethyl gallate or norepinephrine in respective groups. In the late treatment protocol, we administered ethyl gallate or norepinephrine after a sustained ∼5-hr decrease in mean arterial pressure to 60 mm Hg and continued the infusion for the duration of the experiment. We followed parameters for over 10 hrs after the initiation of P. aeruginosa in both groups. We measured stroke work, urine output, serum creatinine, among other parameters, and used serum troponin T as an index of myocardial injury. We found that in both protocols, ethyl gallate and norepinephrine improved mean arterial pressure and stroke work to similar extents over the duration of the study. Particularly in the late treatment protocol, ethyl gallate resulted in a lower heart rate, a lower troponin T, and a greater urine output as compared with norepinephrine (p.05).These results suggest that phenolic antioxidants, such as ethyl gallate, that inhibit hydrogen peroxide signaling, may represent an alternative class of vasopressors for use in septic shock. |
| Databáze: | OpenAIRE |
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