High level of arginine vasopressin and 7.5% NaCl/6% dextran-70 solution: cardiovascular and renal effects.
A marked diuresis has been observed following resuscitation of hypotensive hemorrhaged animals with small volume hypertonic saline/dextran (HSD), 7.5% NaCl/6% dextran-70. We tested the hypothesis that high arginine vasopressin (AVP) levels associated with severe hemorrhage may exacerbate the diuretic effect of HSD infusion in euvolemic sheep. Following AVP infusion, a significant bradycardia (55% of baseline) and decreased cardiac output (62% of baseline) was observed (p < or = .05). Urine output increased during AVP infusion (25.4 +/- 2.3 ml/20 min) compared to control group (10.5 +/- 1.0 ml/20 min) (p < or = .0001). With HSD volume expansion, urine flow in the AVP group was initially 1.7 times greater than the control group (104.8 +/- 10 ml/20 min vs. 60.2 +/- 15 ml/20 min) (p < or = .05). High serum levels of AVP (600 +/- 33 pg/ml) may contribute to the diuresis seen with HSD resuscitation and possibly contribute to the bradycardia observed with severe hemorrhage.
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Department of Surgery, University of California at Davis School of Medicine 95616, USA.
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Gunther
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D000818:Animals; D001127:Arginine Vasopressin / Q000097:blood*; D002319:Cardiovascular System / Q000187:drug effects* / Q000503:physiopathology; D003911:Dextrans / Q000494:pharmacology*; D004195:Disease Models, Animal; D006439:Hemodynamics / Q000187:drug effects*; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D012756:Sheep; D012771:Shock, Hemorrhagic / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D012965:Sodium Chloride / Q000494:pharmacology*
D003911:Dextrans; D001127:Arginine Vasopressin; D012965:Sodium Chloride