• I Bauer, R Truse, C Vollmer, J Hinterberg, and O Picker.
• Department of Anaesthesiology, University Hospital Duesseldorf, Duesseldorf, Germany.
• Shock. 2015 Oct 1;44 Suppl 2:3.

IntroductionLocal drug application is used to avoid systemic side effects. We analysed whether locally applied Iloprost (PGI2-analogue) or Nitroglycerin (NO-donor) influence gastric mucosal perfusion (μflow) and oxygenation (μHbO2) during physiological and haemorrhagic conditions.MethodsWith approval of the local animal care and use committee five foxhounds were repeatedly anaesthetized (randomized cross-over design). Animals received Nitroglycerin (25 μg/kg followed by 8.3 μg/kg/min) or Iloprost (100 ng/kg followed by 30 ng/kg/min) or NaCl (control) with or without haemorrhage (20% estimated blood volume, 60 min) followed by retransfusion of the shed blood. Systemic haemodynamic variables, μflow (laser doppler) and μHbO2 (reflectance spectrophotometry) were recorded continuously. Arterial blood was sampled intermittently for blood gas analysis and calculation of systemic oxygen delivery (DO2). Data are means ± SEM. 2-way ANOVA+Dunnett's for multiple comparisons, p < 0.05.ResultsUnder physiological conditions, NO but not PGI2 increased gastric μflow from 95 ± 12 to 141 ± 24 aU without affecting μHbO2 or systemic haemodynamic variables. Under haemorrhagic conditions, μHbO2 decreased from 78 ± 2 % to 37 ± 3 %. This was attenuated by NO (decrease from 80 ± 2 to 47 ± 6 %) and PGI2 (from 82 ± 1 to 54 ± 4 %). In contrast, μflow decreased during haemorrhage without differences between the groups. These effects were independent of DO2 and cardiac output, which were equally reduced in both groups. Under physiological conditions NO induces a local vasodilation. During haemorrhagic shock NO and PGI2 improve regional oxygenation without affecting μflow.ConclusionLocal drug application improves gastric microcirculation without compromising systemic haemodynamic variables.FundingStrategischer Forschungsfonds.

14 keywords...

hide…