Effects of N-acetylcysteine and terbutaline treatment on hemodynamics and regional albumin extravasation in porcine septic shock

Journal Article · Thu Mar 01 04:00:00 EST 1990 · Circulatory Shock; (USA)

OSTI ID:6854694

Groeneveld, A B; den Hollander, W; Straub, J; Nauta, J J; Thijs, L G ^[1]

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1. Free Univ. Hospital, Amsterdam (Netherlands)

We studied the therapeutic effects of continuously infused N-acetylcysteine, an O2 radical scavenger (N, n = 6), and terbutaline, a beta 2-agonist (T, n = 6), versus dextrose (controls C, N = 6) on hemodynamics and regional albumin extravasation in porcine septic shock. After instrumentation, injection of 99mTc-labeled red blood cells, and baseline measurements, pigs received a 90 min infusion of 11 +/- 9 X 10(8).kg-1 live Escherichia coli bacteria. Thereafter, therapy was started, and 131I human serum albumin was injected. Images were obtained hourly using a gamma camera and a computer until 5 hours after baseline. Regions of interest were drawn in the 99mTc images, yielding regional 131I/99mTc radioactivity ratios, with blood samples as reference. From these ratios, an albumin leak index, a rate constant of transvascular albumin transport, was calculated. Control pigs developed pulmonary hypertension, arterial hypotension, hemoconcentration, and lactic acidemia. In spite of tachycardia and unchanged filling pressures, cardiac output fell. In arterial blood, white cell count, PO2, albumin level, and colloid osmotic pressure fell. The albumin leak index (X10(-3).min-1) measured 1.56 +/- 0.59 over the lungs and 2.87 +/- 1.19 over the abdomen in C, confirming previously found increased albumin flux in both lung and abdomen, the latter exceeding the former. Neither N nor T significantly affected hemodynamic and biochemical changes. The drugs neither decreased the regional albumin leak index nor attenuated the formation of albumin-rich ascites found at autopsy. However, the lung albumin index obtained at autopsy was significantly reduced with N (P less than .01 vs. C), at similar gravimetrically determined extravascular lung water (EVLW). EVLW positively correlated with pulmonary albumin extravasation in C and T but not in N.

• OSTI ID: 6854694
• Journal Information: Circulatory Shock; (USA), Journal Name: Circulatory Shock; (USA) Vol. 30:3; ISSN CRSHA; ISSN 0092-6213
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ALBUMINS
AMINO ACIDS
ANIMALS
BACTERIA
BACTERIAL DISEASES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY FLUIDS
CAMERAS
CARBOXYLIC ACIDS
CYSTEINE
DAYS LIVING RADIOISOTOPES
DISEASES
DOMESTIC ANIMALS
DRUGS
ERYTHROCYTES
ESCHERICHIA COLI
GAMMA CAMERAS
HOURS LIVING RADIOISOTOPES
IMAGE PROCESSING
INFECTIOUS DISEASES
INTERMEDIATE MASS NUCLEI
IODINE 131
IODINE ISOTOPES
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MAMMALS
MATERIALS
MICROORGANISMS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC SULFUR COMPOUNDS
PROCESSING
PROTEINS
RADIOISOTOPES
SWINE
TECHNETIUM 99
TECHNETIUM ISOTOPES
THERAPY
THIOLS
VERTEBRATES
YEARS LIVING RADIOISOTOPES