digoxin and Cardiac-Tamponade

Topics: Asthenia; Cardiac Tamponade; Digoxin; Echocardiography; Edema; Erdheim-Chester Disease; Female; Humans; Kidney; Magnetic Resonance Imaging, Cine; Middle Aged; Prognosis

Three structurally related peptides, ovine corticotropin-releasing factor, sauvagine, and urotensin I are selective mesenteric vasodilators in dogs. To assess the possible benefit of these peptides in nonocclusive mesenteric ischemia, they were compared with a nonselective vasodilator, sodium nitroprusside, in the anesthetized dog. Mesenteric blood flow was reduced by approximately 30%, without lowering of systemic arterial pressure, by either digoxin or pericardial tamponade. In the digoxin model, i.v. infusions of corticotropin-releasing factor, sauvagine, and urotensin I restored intestinal vascular resistance and mesenteric blood flow to control values, without causing a fall in systemic arterial blood pressure. In the tamponade model, only urotensin I was assessed, and it produced the same restoration of hemodynamic variables. On the other hand, in both models, i.v. infusions of nitroprusside, which were effective in correcting intestinal vascular resistance, produced a fall in arterial blood pressure (presumably because of systemic dilatation), which prevented restoration of mesenteric blood flow. Intestinal oxygen uptake was not altered by tamponade, but was reduced by 23% in the digoxin model, where it was restored to control values by both the peptides and nitroprusside. The increased oxygen extraction seen in both models was corrected by the peptides but not by nitroprusside, suggesting that nitroprusside may have a direct and offsetting metabolic effect on the gut.

Topics: Amphibian Proteins; Animals; Blood Pressure; Cardiac Tamponade; Corticotropin-Releasing Hormone; Digoxin; Diuresis; Dogs; Female; Ischemia; Male; Mesenteric Arteries; Mesenteric Veins; Nitroprusside; Peptide Hormones; Peptides; Splanchnic Circulation; Urotensins; Vascular Resistance; Vasodilator Agents

The local hemodynamic response of the innervated but vascularly isolated colon to decreased systemic perfusion induced by cardiac tamponade was studied in anesthesized dogs as a model of nonocclusive mesenteric ischemia. Increasing levels of pericardial pressure caused progressive decreases in colonic blood flow associated with substantial increases in colonic vascular resistance. These increases in local colonic resistance were proportionately larger than concurrent increases in systemic resistance. The disproportionate response of the colonic resistance vessels was not diminished by colonic (sympathetic) denervation. Reductions of blood flow to 30 ml . min-1 . 100 g-1 resulted in compensatory increases in colonic oxygen extraction such that colonic oxygen consumption remained constant (flow independent) at about 1.5 ml . min-1 . 100 g-1. At blood flows below 30 ml . min-1 . 100 g-1 colonic oxygen consumption was markedly dependent on blood flow. This fundamental relation of colonic oxygen consumption to blood flow was the same whether ischemia was induced by cardiac tamponade, partial mechanical arterial occlusion, or vasoconstrictor (norepinephrine or digoxin) infusion. Furthermore, this relationship was not altered by vasodilation with isoproterenol after the induction of ischemia by any of the above means.

Topics: Animals; Blood Pressure; Cardiac Output; Cardiac Tamponade; Colon; Digoxin; Dogs; Kinetics; Norepinephrine; Oxygen Consumption; Regional Blood Flow; Vascular Resistance

Topics: Acid-Base Imbalance; Acute Kidney Injury; Blood Volume; Cardiac Surgical Procedures; Cardiac Tamponade; Child; Child, Preschool; Digoxin; Humans; Hypokalemia; Infant; Patient Care Team; Postoperative Care; Postoperative Complications