Amrinone during porcine intraperitoneal sepsis.
Seven Yucatan minipigs with chronic, severe intraperitoneal sepsis were given amrinone i.v. (loading dose of 0.75 mg/kg, followed by continuous infusion of 10, 20, 40, and 80 micrograms/kg/min) during the hyperdynamic phase of sepsis. Hemodynamic variables and oxygen utilization, delivery, and extraction were recorded throughout the study. Pulmonary capillary wedge pressure was kept constant to ensure a fixed ventricular filling pressure. Intravenous amrinone modestly augmented cardiac index without altering heart rate. Mean systemic and pulmonary arterial pressures decreased. Systemic and pulmonary vascular resistance fell significantly (P less than 0.05). Amrinone did not significantly alter oxygen utilization or oxygen extraction, although oxygen delivery increased (P less than .05). During the hyperdynamic phase of sepsis in this animal model, amrinone elicits vasodilatation with a modest improvement in stroke volume index. Consequently, cardiac output and oxygen delivery increased modestly. Because of its vasodilating properties and small salutary effects, amrinone is not an optimal first-line medication for hemodynamic stabilization during hyperdynamic sepsis.
Naval Medical Research Institute, Bethesda, MD 20814-5055.
J B
JB
Hermiller
J P
JP
Mehegan
V M
VM
Nadkarni
J A
JA
Paschall
J J
JJ
Nevola
M A
MA
Fletcher
T J
TJ
Williams
D000676:Amrinone / Q000494:pharmacology*; D000818:Animals; D004305:Dose-Response Relationship, Drug; D004927:Escherichia coli Infections / Q000378:metabolism / Q000503:physiopathology*; D006439:Hemodynamics / Q000187:drug effects; D007275:Injections, Intravenous; D008297:Male; D010101:Oxygen Consumption / Q000187:drug effects; D010532:Peritoneal Diseases / Q000378:metabolism / Q000503:physiopathology*; D013552:Swine; D013556:Swine, Miniature
D000676:Amrinone