Einfluss des selektiven iNOS-Inhibitors 1400W auf die exkretorische Leberfunktion im Endotoxinschock am Schwein
Schober, Gabriel Matthias
LicenseStandard (Fassung vom 03.05.2003)
OBJECTIVE: To investigate whether the selective iNOS-inhibition using 1400W is able to attenuate the decrease of excretory liver function in a clinically relevant model of long-term, hyperdynamic porcine endotoxemia. DESIGN AND SETTING: Prospective experimental study in the animal laboratory in a university hospital. SUBJECTS: twenty-one domestic pigs. INTERVENTIONS: Pigs were anaesthetized, mechanically ventilated, and instrumented. After 12 h of continuous i.v. endotoxin (LPS) infusion pigs received either no drug (ETX, n = 12) or 1400W, titrated to maintain mean arterial pressure (MAP) at pre-endotoxin level (n = 9). Measurements were obtained before, 12 h and 24 h after starting LPS infusion. MEASUREMENTS AND RESULTS: Excretory liver function was assessed by quantitative bile excretion, biliary ICG excretion, biliary HCO3 excretion and PDR of ICG. Our measurements included also the portal venous and hepatic arterial blood flow, the regional O2-exchange and the expiratory NO amount. Despite unchanged regional blood flow, O2-exchange and PDR of ICG we found a significant fall of quantitative bile excretion, biliary ICG excretion and biliary HCO3 excretion during endotoxemia. Treatment with 1400W was able to reduce the fall of quantitative bile excretion and biliary ICG excretion, but not of biliary ICG excretion. Expiratory NO level was significant elevated in endotoxemia and dropped again after treatment. CONCLUSION: Our model was able to demonstrate the changes of excretory liver function in hyperdynamic septic shock. Treatment with 1400W alone reduced the significant changes in quantitative bile excretion and biliary HCO3 excretion, but not of biliary ICG excretion. Surprisingly there was no change of PDR of ICG suggesting a careful interpretation of this parameter as bedside test in clinical use.
Subject HeadingsEndotoxin [GND]
Shock, endotoxic [MeSH]