Abstract
Cardiovascular collapse is a common cause of death in newborn sepsis. Vasodilator therapy has recently been suggested to be of significant hemodynamic benefit in a number of shock states. We assessed the effects of nitroglycerin (NG), a direct-acting smooth muscle relaxant, on systemic and pulmonary hemodynamics in a piglet model of Group 8 Streptococcal sepsis.
Piglets (n=4) were anaesthetized, intubated, and ventilated. Systemic blood pressure (BP), pulmonary artery pressure (PAP), cardiac output (CO), and heart rate (HR) were monitored directly and continuously. Sepsis was induced by continuous infusion of serotype Ib Group B Streptococci (GBS) @ approximately 5 × 107 organisms/kg/min. Ventricular filling pressures were held constant during the entire experiment by adjustment of i.v. infusion rate.
After 30 minutes of GBS infusion, CO fell by 32 ± 7% (S.D.), PAP rose by 225 ± 97% (both p< 0.01) while BP fell by 1 ± 6% and HR rose b 4 ± 4% (both p = N.S.) While GBS infusion continued, NG infusion was begun. For NG @ 8 mcg/kg/min and 16 mcg/kg/min respectively, CO fell by 7 ± 9% (p = N.S.) and 19 ± 11% (p< 0.01), BP fell by 9 ± 6% (p< 0.05) and 13 ± 4% (p< 0.01), PAP rose by 2 ± 9% and 4 ± 16% (both p = N.S.), and HR rose by 7 ± 9% (p = N.S.) and 11 ± 6% (p< 0.05).
Conclusion: NG infusion during GBS sepsis in piglets had little apparent hemodynamic benefit.
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Meadow, W., Rudinsky, B., Strates, E. et al. 395 HEMODYNAMIC CONSEQUENCES OF NITROGLYCERIN INFUSION DURING GROUP B STREPTOCOCCAL SEPSIS IN PIGLETS. Pediatr Res 19, 176 (1985). https://doi.org/10.1203/00006450-198504000-00425
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DOI: https://doi.org/10.1203/00006450-198504000-00425