TITLE

Hepatic O2 exchange and liver energy metabolism in hyperdynamic porcine endotoxemia: effects of iloprost

AUTHOR(S)
Träger, Karl; Matejovic, Martin; Zülke, Carl; Vlatten, Arnim; Vogt, Josef; Wachter, Ulrich; Altherr, Jürgen; Brinkmann, Alexander; Jauch, Karl W.; Georgieff, Michael; Radermacher, Peter
PUB. DATE
October 2000
SOURCE
Intensive Care Medicine;Oct2000, Vol. 26 Issue 10, p1531
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To compare the effects of a 12 h continuous infusion of iloprost, a stable prostacyclin analogue, on hepatic blood flow (Qliv), O2 exchange, and energy metabolism during a 24 h hyperdynamic, porcine endotoxemia with volume resuscitation alone. Design: Prospective, randomized, experimental study with repeated measures. Setting: Investigational animal laboratory. Subjects: Twenty-eight domestic pigs: 16 animals during endotoxemia with volume resuscitation alone (ETX), 12 with endotoxemia, volume resuscitation, and treatment with iloprost (ILO). Interventions: Endotoxemia was initiated by continuous infusion of E. coli lipopolysaccharide. Animals were resuscitated with hetastarch, aimed at maintaining a MAP of >60 mmHg. After 12 h of endotoxemia, iloprost was administered for 12 h in the treatment group, titrated to avoid pharmacologically induced hypotension (MAP <60 mmHg). Measurements and results: Iloprost significantly increased Qliv, with no effect on hepatic O2 delivery. Mean capillary hemoglobin O2 saturation (HbScO2) on the liver surface, as well as HbScO2 frequency distributions –- a measure of microcirculatory O2 availability –- remained unchanged. Treatment with iloprost, however, significantly attenuated the endotoxin-induced derangements of cellular energy metabolism as reflected by the diminished progressive decrease in hepatic lactate uptake rate and a blunted increase in hepatic venous lactate/pyruvate ratios. While endotoxin significantly increased endogenous glucose production (EGP) rate, iloprost restored EGP to normal at the end of the experiment. Conclusions: Thus, in a clinically relevant model of human sepsis, iloprost did not produce potential adverse effects but rather ameliorated hepatic metabolic disturbances and, thereby, hepatic energy balance.
ACCESSION #
15729172

 

Related Articles

  • Prostacyclin Reduces Symptoms and Sympathetic Dysfunction in Erythromelalgia in a Double-blind Randomized Pilot Study. Kalgaard, Ole M.; Mørk, Cato; Kvernebo, Knut // Acta Dermato-Venereologica;Nov2003, Vol. 83 Issue 6, p442 

    Sympathetic dysfunction and skin microvascular arteriovenous shunting with insufficient nutritive perfusion and tissue hypoxia have been reported in patients with erythromelalgia. The objective of this study was to determine whether iloprost, a synthetic prostacyclin analogue - primarily a...

  • Short-term outcome of painful bone marrow oedema of the knee following oral treatment with iloprost or tramadol: results of an exploratory phase II study of 41 patients. M. E. Mayerhoefer; J. Kramer; M. J. Breitenseher; C. Norden; A. Vakil-Adli; S. Hofmann; R. Meizer; H. Siedentop; F. Landsiedl; N. Aigner // Rheumatology;Aug2007, Vol. 46 Issue 9, p1460 

    Objectives. To compare the therapeutic effects of oral iloprost and tramadol on the outcome of bone marrow oedema (BME) of the knee by MR imaging and clinical assessment. Methods. Forty-one patients with painful ischemic or mechanical BME of the knee were enrolled in a double-blind, randomized...

  • The Estimation of Hepatic Blood Flow with Indocyanine Green: Comparison between the Continuous Infusion and Single Injection Methods. Villeneuve, J. P.; Marleau, D.; Huet, P. M. // American Journal of Gastroenterology;Apr1982, Vol. 77 Issue 4, p233 

    We compared the estimation of hepatic blood flow obtained using a continuous infusion of indocyanine green with that obtained after a single intravenous injection of indocyanine green in 35 patients with liver disease. There was no significant difference in the values of hepatic blood flow...

  • Effectiveness of therapy with iloprost in hand—arm vibration syndrome. Meloni, Michele; Torrazza, Mario; Ledda, Roberto // Occupational Medicine;Jun2004, Vol. 54 Issue 4, p261 

    AimTo evaluate the efficacy and tolerance of therapy with iloprost in hand–arm vibration syndrome.MethodsWe describe a clinical case of a male aged 53 years, who was a heavy smoker for 30 years and a mason working with vibrating tools since 1962. He presented with a history of 10 years of...

  • Inhaled Iloprost for Severe Pulmonary Hypertension. Olschewski, Horst; Simonneau, Gerald; Galiè, Nazzareno; Higenbottam, Timothy; Naeije, Robert; Rubin, Lewis J.; Nikkho, Sylvia; Speich, Rudolf; Hoeper, Marius M.; Behr, Jürgen; Winkler, Jörg; Sitbon, Olivier; Popov, Wladimir; Ghofrani, H. Ardeschir; Manes, Alessandra; Kiely, David G.; Ewert, Ralph; Meyer, Andreas; Corris, Paul A.; Delcroix, Marion // New England Journal of Medicine;8/1/2002, Vol. 347 Issue 5, p322 

    Background: Uncontrolled studies suggested that aerosolized iloprost, a stable analogue of prostacyclin, causes selective pulmonary vasodilatation and improves hemodynamics and exercise capacity in patients with pulmonary hypertension. Methods: We compared repeated daily inhalations of 2.5 or...

  • Iloprost infusion does not reduce oxidative stress in systemic sclerosis. Volpe, Alessandro; Biasi, Domenico; Caramaschi, Paola; Bambara, Lisa Maria; Carletto, Antonio; Degan, Maurizio; Minuz, Pietro // Rheumatology International;Feb2008, Vol. 28 Issue 4, p335 

    Systemic sclerosis is a connective tissue disease in which oxidative stress represents an important player among the complex pathogenetic mechanisms of the disease. Iloprost, an analogue of natural prostacyclin, is used in systemic sclerosis for the treatment of severe Raynaud’s...

  • New treatment OK'd for pulmonary hypertension.  // Drug Topics;1/10/2005, Vol. 149 Issue 1, p6 

    This article reports on the approval of Iloprost Inhalation Solution for the treatment of pulmonary arterial hypertension in patients with New York Heart Association Class III or Class IV symptoms.

  • Inhaled Iloprost: In Primary Pulmonary Hypertension. Goldsmith, David R.; Wagstaff, Antona J. // Drugs;2004, Vol. 64 Issue 7, p763 

    â–´ Iloprost is a stable prostacyclin analogue with a pharmacokinetic profile allowing nebulised administration in patients with primary pulmonary hypertension (PPH). â–´ Inhaled iloprost is a potent acute pulmonary vasodilator with a duration of action of about 60 minutes. It may exert...

  • Iloprost, a Prostacyclin Analog in the Treatment of Advanced Peripheral Arterial Disease. Pessi, Teuvo; Kaukinen, Seppo; Ylitalo, Pauli; Reinikainen, Pekka; Vapaatalo, Heikki // Vascular Surgery;Sep/Oct1986, Vol. 20 Issue 5, p301 

    Iloprost (ZK 36 374), a derivative of carbaprostacyclin, was infused intravenously for seventy-two hours to 10 patients with advanced obliterative peripheral arterial disease. Nine patients reported subjective improvement after the treatment. In 6, the effect lasted for up to two months. In 2,...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics