Is persistent hypotension after transient cardiogenic shock associated with an inflammatory response?

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dc.contributor.authorPark, Marcelo
dc.contributor.authorMaciel, Alexandre Toledo
dc.contributor.authorNoritomi, Danilo Teixeira
dc.contributor.authorBrunialti, Milena Karina Coló [UNIFESP]
dc.contributor.authorSalomão, Reinaldo [UNIFESP]
dc.contributor.authorSchettino, Guilherme de Paula Pinto
dc.contributor.authorAzevedo, Luciano Cesar Pontes [UNIFESP]
dc.contributor.institutionHospital Sírio-Libanês Instituto de Ensino e Pesquisa Laboratório de Pesquisa em Medicina Intensiva e Anestesiologia
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2015-06-14T13:38:40Z
dc.date.available2015-06-14T13:38:40Z
dc.date.issued2008-08-01
dc.description.abstractWe evaluated the recovery of cardiovascular function after transient cardiogenic shock. Cardiac tamponade was performed for 1 h and post-shock data were collected in 5 domestic large white female pigs (43 ± 5 kg) for 6 h. The control group (N = 5) was observed for 6 h after 1 h of resting. During 1 h of cardiac tamponade, experimental animals evolved a low perfusion status with a higher lactate level (8.0 ± 2.2 vs 1.9 ± 0.9 mEq/L), lower standard base excess (-7.3 ± 3.3 vs 2.0 ± 0.9 mEq/L), lower urinary output (0.9 ± 0.9 vs 3.0 ± 1.4 mL·kg-1·h-1), lower mixed venous saturation, higher ileum partial pressure of CO2-end tidal CO2 (EtCO2) gap and a lower cardiac index than the control group. Throughout the 6-h recovery phase after cardiac tamponade, tamponade animals developed significant tachycardia with preserved cardiac index, resulting in a lower left ventricular stroke work, suggesting possible myocardial dysfunction. Vascular dysfunction was present with persistent systemic hypotension as well as persistent pulmonary hypertension. In contrast, oliguria, hyperlactatemia and metabolic acidosis were corrected by the 6th hour. The inflammatory characteristics were an elevated core temperature and increased plasma levels of interleukin-6 in the tamponade group compared to the control group. We conclude that cardiovascular recovery after a transient and severe low flow systemic state was incomplete. Vascular dysfunction persisted up to 6 h after release of tamponade. These inflammatory characteristics may also indicate that inflammatory activation is a possible pathway involved in the pathogenesis of cardiogenic shock.en
dc.description.affiliationHospital Sírio-Libanês Instituto de Ensino e Pesquisa Laboratório de Pesquisa em Medicina Intensiva e Anestesiologia
dc.description.affiliationUniversidade de São Paulo Faculdade de Medicina Hospital das Clínicas
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Departamento de Moléstias Infecciosas Laboratório de Imunologia
dc.description.affiliationUnifespUNIFESP, Depto. de Moléstias Infecciosas Laboratório de Imunologia
dc.description.sourceSciELO
dc.format.extent648-656
dc.identifierhttps://dx.doi.org/10.1590/S0100-879X2008000800002
dc.identifier.citationBrazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 41, n. 8, p. 648-656, 2008.
dc.identifier.doi10.1590/S0100-879X2008000800002
dc.identifier.fileS0100-879X2008000800002.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2008000800002
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/4502
dc.identifier.wosWOS:000259282600002
dc.language.isoeng
dc.publisherAssociação Brasileira de Divulgação Científica
dc.relation.ispartofBrazilian Journal of Medical and Biological Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCardiogenic shocken
dc.subjectCardiac tamponadeen
dc.subjectSystemic inflammatory response syndromeen
dc.subjectSwineen
dc.subjectMyocardial dysfunctionen
dc.subjectInflammationen
dc.titleIs persistent hypotension after transient cardiogenic shock associated with an inflammatory response?en
dc.typeinfo:eu-repo/semantics/article
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