title: Experimental sepsis in pigs--effects of vasopressin on renal, hepatic, and intestinal dysfunction.
abstract: BACKGROUND
  Low-dose arginine vasopressin (AVP) has been proposed as an adjunctive vasopressor for the treatment of advanced vasodilatory shock. However, its effects on renal, hepatic, and intestinal dysfunction during sepsis remain controversial.
  
  
  METHODS
  Fecal peritonitis was induced in 20 anesthetized, invasively monitored, mechanically ventilated female pigs. Following the time point of septic shock (defined as mean artery pressure (MAP) ≤65 mmHg), animals were randomly assigned to the following groups (n = 10): 1) a norepinephrine group with MAP between 65 and 75 mmHg; and 2) an AVP group with a constant infusion rate of 0.5 mU.kg(-1).min(-1).
  
  
  RESULTS
  MAP, pulmonary capillary wedge pressure, hematocrit, TNF-α, IL-6, and IL-10 were similar in the two groups during the 28-h observation period. Infusion of AVP was associated with lower total norepinephrine and fluid requirements. There was a statistically significant improvement in renal function as assessed by increased urine output and renal blood flow, and decreased serum creatinine, in the AVP group when compared with the norepinephrine group (P < 0.05). Histological analyses of the intestine, liver, and kidney showed similar light microscopical appearance of the two groups. Apoptotic cells in the liver were significantly fewer in the AVP group when compared with the norepinephrine group (P < 0.05).
  
  
  CONCLUSIONS
  An adjunctive AVP to norepinephrine infusion exhibits a favorable impact on renal function without deleterious effects on the liver and intestine in a porcine model of experimental sepsis when compared with norepinephrine infusion alone.
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, P. R. China.
authors.forename: Mu-Huo
authors.initials: MH
authors.lastname: Ji
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Yang
authors.forename: Jing
authors.initials: J
authors.lastname: Wu
authors.forename: Ren-Qi
authors.initials: RQ
authors.lastname: Li
authors.forename: Guo-Min
authors.initials: GM
authors.lastname: Li
authors.forename: Yun-Xia
authors.initials: YX
authors.lastname: Fan
authors.forename: Wei-Yan
authors.initials: WY
authors.lastname: Li
mesh_terms: D000818:Animals; D016207:Cytokines / Q000378:metabolism; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000187:drug effects* / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D008099:Liver / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D018805:Sepsis / Q000188:drug therapy* / Q000503:physiopathology*; D013552:Swine; D014667:Vasopressins / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D016207:Cytokines; D014667:Vasopressins