Effects of Reversal of Hypotension on Cerebral Microcirculation and Metabolism in Experimental Sepsis
Fabio Silvio Taccone,
Fuhong Su,
Xinrong He,
Lorenzo Peluso,
Katia Donadello,
Sabino Scolletta,
Daniel De Backer,
Jean-Louis Vincent
Affiliations
Fabio Silvio Taccone
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
Fuhong Su
Laboratoire Experimental des Soins Intensifs, Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
Xinrong He
Laboratoire Experimental des Soins Intensifs, Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
Lorenzo Peluso
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
Katia Donadello
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
Sabino Scolletta
Laboratoire Experimental des Soins Intensifs, Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
Daniel De Backer
Laboratoire Experimental des Soins Intensifs, Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
Jean-Louis Vincent
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
The effects of reversal of hypotension on the cerebral microcirculation, oxygenation, and metabolism in septic shock remain unclear. In 12 sheep, peritonitis was induced by injection of feces into the abdominal cavity. At the onset of septic shock (mean arterial pressure (MAP) 2) was measured, and cerebral metabolism was assessed using microdialysis. All animals developed septic shock after a median of 15 (14–19) h. When MAP was raised using norepinephrine, the PbtO2 increased significantly (from 41 ± 4 to 55 ± 5 mmHg), and the cerebral lactate/pyruvate ratio decreased (from 47 ± 13 to 28 ± 4) compared with values at shock onset. Changes in the microcirculation were unchanged with restoration of MAP and the glutamate increased further (from 17 ± 11 to 23 ± 16 μM), as it did in the untreated animals. In septic shock, the correction of hypotension with vasopressors may improve cerebral oxygenation but does not reverse the alterations in brain microcirculation or cerebral metabolism.
