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Arginine vasopressin reduces cerebral oxygenation and cerebral blood volume during intact circulation in swine – a near infrared spectroscopy study

Published online by Cambridge University Press:  13 April 2005

B. Bein
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Germany
E. Cavus
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Germany
V. Dörges
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Germany
K.-H. Stadlbauer
Affiliation:
Leopold-Franzens University, Department of Anaesthesiology and Intensive Care Medicine, Innsbruck, Austria
P. H. Tonner
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Germany
M. Steinfath
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Germany
J. Scholz
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Germany
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Extract

Summary

Background and objective: The aim of the present study was to investigate the impact of arginine vasopressin (AVP), a drug currently under investigation for use during cardiopulmonary resuscitation, on cerebral oxygenation and cerebral blood volume (CBV) in pigs with intact systemic circulation using near infrared spectroscopy.

Methods: Nine healthy pigs were anaesthetized and subjected to invasive haemodynamic monitoring as well as to non-invasive determination (with near infrared spectroscopy) of changes in the Tissue Oxygenation Index (TOI is the ratio of oxygenated to total tissue haemoglobin), Tissue Haemoglobin Index (THI, representing CBV) and cytochrome oxidase (ΔCytOx, representing the balance of intracellular oxygen supply).

Results: At both 3 and 5 min after AVP administration, TOI, THI and ΔCytOx were significantly (P < 0.001) reduced compared to baseline, while cerebral perfusion pressure increased significantly (P < 0.001). The effects of AVP on TOI and THI lasted longer than on ΔCytOx. There were no significant changes with respect to the intracranial pressure throughout the study period.

Conclusions: No improvement of cerebral oxygenation was detected after AVP administration in swine with an intact systemic circulation. In contrast to recently published investigations, AVP provoked a sustained drop in indices of cerebral oxygenation and CBV.

Type
Original Article
Copyright
© 2005 European Society of Anaesthesiology

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References

Paradis NA, Koscove EM. Epinephrine in cardiac arrest: a critical review. Ann Emerg Med 1990; 19: 12881301.Google Scholar
Wenzel V, Krismer AC, Voelckel WG, et al. The use of arginine vasopressin during cardiopulmonary resuscitation. An analysis of experimental and clinical experience and a view of the future. Anaesthesist 2002; 51: 191202.Google Scholar
Wenzel V, Linder KH, Augenstein S, Prengel AW, Strohmenger HU. Vasopressin combined with epinephrine decreases cerebral perfusion compared with vasopressin alone during cardiopulmonary resuscitation in pigs. Stroke 1998; 29: 14621467; discussion 7–8.Google Scholar
Prengel AW, Lindner KH, Keller A. Cerebral oxygenation during cardiopulmonary resuscitation with epinephrine and vasopressin in pigs. Stroke 1996; 27: 12411248.Google Scholar
Lindner KH, Dirks B, Strohmenger HU, et al. Randomised comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation. Lancet 1997; 349: 535537.Google Scholar
Stiell IG, Hebert PC, Wells GA, et al. Vasopressin versus epinephrine for inhospital cardiac arrest: a randomised controlled trial. Lancet 2001; 358: 105109.Google Scholar
Nishizawa H, Kudoh I. Cerebral autoregulation is impaired in patients resuscitated after cardiac arrest. Acta Anaesthesiol Scand 1996; 40: 11491153.Google Scholar
Sundgreen C, Larsen FS, Herzog TM, et al. Autoregulation of cerebral blood flow in patients resuscitated from cardiac arrest. Stroke 2001; 32: 128132.Google Scholar
Katusic ZS, Shepherd JT, Vanhoutte PM. Vasopressin causes endothelium-dependent relaxations of the canine basilar artery. Circ Res 1984; 55: 575579.Google Scholar
Faraci FM, Mayhan WG, Schmid PG, Heistad DD. Effects of arginine vasopressin on cerebral microvascular pressure. Am J Physiol 1988; 255: H70H76.Google Scholar
Faraci FM. Effects of endothelin and vasopressin on cerebral blood vessels. Am J Physiol 1989; 257: H799H803.Google Scholar
Kuebler WM, Sckell A, Habler O, et al. Noninvasive measurement of regional cerebral blood flow by near-infrared spectroscopy and indocyanine green. J Cereb Blood Flow Metab 1998; 18: 445456.Google Scholar
Brown DW, Picot PA, Naeini JG, et al. Quantitative near infrared spectroscopy measurement of cerebral hemo-dynamics in newborn piglets. Pediatr Res 2002; 51: 564570.Google Scholar
Doornbos RM, Lang R, Aalders MC, Cross FW, Sterenborg HJ. The determination of in vivo human tissue optical properties and absolute chromophore concentrations using spatially resolved steady-state diffuse reflectance spectroscopy. Phys Med Biol 1999; 44: 967981.Google Scholar
Wagner BP, Pfenninger J. Dynamic cerebral autoregulatory response to blood pressure rise measured by near-infrared spectroscopy and intracranial pressure. Crit Care Med 2002; 30: 20142021.Google Scholar
Quaresima V, Sacco S, Totaro R, Ferrari M. Noninvasive measurement of cerebral hemoglobin oxygen saturation using two near infrared spectroscopy approaches. J Biomed Opt 2000; 5: 201205.Google Scholar
Sakamoto T, Jonas RA, Stock UA, et al. Utility and limitations of near-infrared spectroscopy during cardiopulmonary bypass in a piglet model. Pediatr Res 2001; 49: 770776.Google Scholar
Tiecks FP, Lam AM, Aaslid R, Newell DW. Comparison of static and dynamic cerebral autoregulation measurements. Stroke 1995; 26: 10141019.Google Scholar
Hauerberg J, Xiaodong M, Willumsen L, Pedersen DB, Juhler M. The upper limit of cerebral blood flow auto-regulation in acute intracranial hypertension. J Neurosurg Anesthesiol 1998; 10: 106112.Google Scholar
Paulson OB, Waldemar G, Schmidt JF, Strandgaard S. Cerebral circulation under normal and pathologic conditions. Am J Cardiol 1989; 63: 2C5C.Google Scholar
Suzuki Y, Satoh S, Kimura M, et al. Effects of vasopressin and oxytocin on canine cerebral circulation in vivo. J Neurosurg 1992; 77: 424431.Google Scholar
Suzuki Y, Satoh S, Oyama H, Takayasu M, Shibuya M. Regional differences in the vasodilator response to vasopressin in canine cerebral arteries in vivo. Stroke 1993; 24: 10491053; discussion 53–54.Google Scholar
Tsugane S, Suzuki Y, Kano T, et al. Differing effects of vasopressin on regional cerebral blood flow of dogs following intracisternal vs.intra-arterial administration. Life Sci 1994; 54: L241L246.Google Scholar
Hennigan TW, Allen-Mersh TG. Duration of blood flow reduction to normal liver tissue induced by angiotensin, vasopressin and endothelin. Eur J Surg Oncol 1994; 20: 446448.Google Scholar
Moreau R, Hadengue A, Soupison T, et al. Abnormal pressor response to vasopressin in patients with cirrhosis: evidence for impaired buffering mechanisms. Hepatology 1990; 12: 712.Google Scholar
Al-Rawi PG, Smielewski P, Kirkpatrick PJ. Evaluation of a near-infrared spectrometer (NIRO 300) for the detection of intracranial oxygenation changes in the adult head. Stroke 2001; 32: 24922500.Google Scholar
Delpy DT, Cope M, van der Zee P, et al. Estimation of optical pathlength through tissue from direct time of flight measurement. Phys Med Biol 1988; 33: 14331442.Google Scholar