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101/06月份題目:
*雜誌研討會(journal meeting):
101/6/20
日期
主講人 陳佳文醫師
地點
5A討論室
時間
15:30~16:30
Renal bioenergetics during early gram-negative mammalian sepsis and angiotensin II infusion
題目
Intensive Care Medicine38. 5 (May 2012): 886-893.
出處
Abstract
To measure renal adenosine triphosphate (ATP) (bioenergetics) during hypotensive sepsis with or without
angiotensin II (Ang II) infusion.
In anaesthetised sheep implanted with a renal artery flow probe and a magnetic resonance coil around
one kidney, we induced hypotensive sepsis with intravenous Escherichia coli injection. We measured mean
arterial pressure (MAP), heart rate, renal blood flow RBF and renal ATP levels using magnetic resonance
spectroscopy. After 2 h of sepsis, we randomly assigned sheep to receive an infusion of Ang II or vehicle
intravenously and studied the effect of treatment on the same variables.
After E. coli administration, the experimental animals developed hypotensive sepsis (MAP from 92 ± 9 at
baseline to 58 ± 4 mmHg at 4 h). Initially, RBF increased, then, after 4 h, it decreased below control levels
(from 175 ± 28 at baseline to 138 ± 27 mL/min). Despite decreased RBF and hypotension, renal ATP was
unchanged (total ATP to inorganic phosphate ratio from 0.69 ± 0.02 to 0.70 ± 0.02). Ang II infusion
restored MAP but caused significant renal vasoconstriction. However, it induced no changes in renal ATP
(total ATP to inorganic phosphate ratio from 0.79 ± 0.03 to 0.80 ± 0.02).
During early hypotensive experimental Gram-negative sepsis, there was no evidence of renal bioenergetic
failure despite decreased RBF. In this setting, the addition of a powerful renal vasoconstrictor does not
lead to deterioration in renal bioenergetics