title: Beneficial Effects of Norepinephrine Alone on Cardiovascular Function and Tissue Oxygenation in a Pig Model of Cardiogenic Shock.
abstract: The present study was developed to investigate the effects of norepinephrine alone on hemodynamics and intrinsic cardiac function in a pig model of cardiogenic shock mimicking the clinical setting.
  
  
  
  Cardiogenic shock was induced by 1-h ligation of the left anterior descending (LAD) artery followed by reperfusion. Pigs were monitored with a Swan-Ganz catheter, a transpulmonary thermodilution catheter, and a conductance catheter placed in the left ventricle for pressure-loop measurements. Measurements were performed before LAD occlusion, 1 h after LAD occlusion, and 4 h after myocardial reperfusion.
  
  
  
  Myocardial infarction and reperfusion was followed by cardiogenic shock characterized by a significant increase in heart rate and significant decreases in mean arterial pressure (MAP), mixed venous oxygen saturation (SVO2), left ventricular end-diastolic pressure (LVEDP), prerecruitable stroke work (PRSW), and cardiac power index (CPI). Lactate levels were significantly increased. The systemic vascular resistance index (SVRI) and global end-diastolic volume index (GEDVI) remained unchanged. When compared with the control group (n = 6), norepinephrine infusion (n = 6) was associated with no changes in heart rate, a significant increase in MAP, SVO2, left ventricular ejection fraction, pressure development during isovolumic contraction, SVRI, and CPI and a decrease in lactate level. Cardiac index tended to increase (P = 0.059), whereas PRSW did not change in the norepinephrine group. LVEDP and GEDVI remained unchanged.
  
  
  
  Norepinephrine alone is able to improve hemodynamics, cardiac function, and tissue oxygenation in a pig model of ischemic cardiogenic shock.
authors: *INSERM U1116, Groupe Choc, Faculté de Médecine, Nancy, France †CHU Nancy, Service de Réanimation Médicale Brabois, Pole Cardiovasculaire et Réanimation Médicale, Hôpital Brabois, Nancy, France ‡Université de Lorraine, Nancy, France §School of Surgery Nancy-Lorraine, Faculté de Médecine, Nancy, France ||INSERM, Centre d'Investigations Cliniques-9501 and CHU de Nancy, Nancy, France ¶Service de chirurgie cardiaque et transplantations, Pole Cardiovasculaire et Réanimation Médicale, Hôpital Brabois, Nancy, France.
authors: Alexandra
authors: A
authors: Beurton
authors: Nicolas
authors: N
authors: Ducrocq
authors: Thomas
authors: T
authors: Auchet
authors: Frédérique
authors: F
authors: Joineau-Groubatch
authors: Aude
authors: A
authors: Falanga
authors: Antoine
authors: A
authors: Kimmoun
authors: Nicolas
authors: N
authors: Girerd
authors: Renaud
authors: R
authors: Fay
authors: Fabrice
authors: F
authors: Vanhuyse
authors: Nguyen
authors: N
authors: Tran
authors: Bruno
authors: B
authors: Levy
mesh_terms: D000818:Animals; D062186:Arterial Pressure / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D008297:Male; D009638:Norepinephrine / Q000627:therapeutic use*; D010101:Oxygen Consumption / Q000187:drug effects; D012770:Shock, Cardiogenic / Q000188:drug therapy*; D013552:Swine; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D009638:Norepinephrine