pituitrin and Wounds-and-Injuries

Traumatic injury ranks as the number one cause of death for the younger than 44 years age group and fifth leading cause of death overall (www.nationaltraumainstitute.org/home/trauma_statistics.html). Although improved resuscitation of trauma patients has dramatically reduced immediate mortality from hemorrhagic shock, long-term morbidity and mortality continue to be unacceptably high during the postresuscitation period particularly as a result of impaired host immune responses to subsequent challenges such as surgery or infection. Acute alcohol intoxication (AAI) is a significant risk factor for traumatic injury, with intoxicating blood alcohol levels present in more than 40% of injured patients. Severity of trauma, hemorrhagic shock, and injury is higher in intoxicated individuals than that of sober victims, resulting in higher mortality rates in this patient population. Necessary invasive procedures (surgery, anesthesia) and subsequent challenges (infection) that intoxicated trauma victims are frequently subjected to are additional stresses to an already compromised inflammatory and neuroendocrine milieu and further contribute to their morbidity and mortality. Thus, dissecting the dynamic imbalance produced by AAI during trauma is of critical relevance for a significant proportion of injured victims. This review outlines how AAI at the time of hemorrhagic shock not only prevents adequate responses to fluid resuscitation but also impairs the ability of the host to overcome a secondary infection. Moreover, it discusses the neuroendocrine mechanisms underlying alcohol-induced hemodynamic dysregulation and its relevance to host defense restoration of homeostasis after injury.

Topics: Alcoholism; Autonomic Nervous System; Ethanol; Hemodynamics; Humans; Neurophysins; Neurosecretory Systems; Protein Precursors; Resuscitation; Shock, Hemorrhagic; Vasopressins; Wounds and Injuries

The management of trauma patients has matured significantly since a systematic approach to trauma care was introduced nearly a half century ago. The resuscitation continuum emphasizes the effect that initial therapy has on the outcome of the trauma patient. The initiation of this continuum begins with prompt field medical care and efficient transportation to designated trauma centers, where lifesaving procedures are immediately undertaken. Resuscitation with packed red blood cells and plasma, in parallel with surgical or interventional radiologic source control of bleeding, are the cornerstones of trauma management. Adjunctive pharmacologic therapy can assist with resuscitation. Tranexamic acid is used in Europe with good results, but the drug is slowly being added to the pharmacy formulary of trauma centers in United States. Recombinant factor VIIa can correct abnormal coagulation values, but its outcome benefit is less clear. Vasopressin shows promise in animal studies and case reports, but has not been subjected to a large clinical trial. The concept of "early goal-directed therapy" used in sepsis may be applicable in trauma as well. An early, appropriately aggressive resuscitation with blood products, as well as adjunctive pharmacologic therapy, may attenuate the systemic inflammatory response of trauma. Future investigations will need to determine whether this approach offers a similar survival benefit.

Topics: Anesthesia; Anesthesiology; Antifibrinolytic Agents; Blood Transfusion; Factor VIIa; Humans; Hypotension, Controlled; Military Personnel; Perioperative Care; Recombinant Proteins; Resuscitation; Tranexamic Acid; Trauma Centers; Vasoconstrictor Agents; Vasopressins; Wounds and Injuries

The evolution of trauma care is driven by a synergistic relationship between civilian and military medical systems. Although the characteristics of civilian injuries differ from those encountered on the battlefield, the pathophysiologic process of dying is the same and dominated by exsanguination and central nervous trauma. As such, therapies that interfere with the physiologic ability to compensate hemorrhage may play a key role to buy time until hemostatic surgery can be initiated. From a variety of remedies with the potential to prolong the compensation phase or to reverse the decompensation phase of shock, arginine vasopressin (AVP) is one of the most promising and best-evaluated drugs. Animal studies and various case report series provide some evidence that AVP may improve blood pressure even when conventional therapies fail, thus preventing hypovolemic cardiac arrest and enabling resuscitation from fatal hemorrhage. On the basis of this civilian experience, it seems reasonable to consider AVP for hypotensive resuscitation in the austere, resource-constrained battlefield environment. However, the significance of AVP as a rescue medication for life-threatening hemorrhage has yet to be proven.

Topics: Hemostatics; Humans; Mass Casualty Incidents; Resuscitation; Shock, Hemorrhagic; Survival Rate; Trauma Severity Indices; Vasopressins; Warfare; Wounds and Injuries

Topics: Addison Disease; Aldosterone; Endocrine Glands; Glomerular Filtration Rate; Humans; Hydrocortisone; Inappropriate ADH Syndrome; Kidney; Parathyroid Hormone; Thyroid Hormones; Vasopressins; Water-Electrolyte Balance; Water-Electrolyte Imbalance; Wounds and Injuries

Topics: Angiotensin II; Animals; Aorta; Arterioles; Blood Pressure; Catecholamines; Diabetes Insipidus; Female; Homeostasis; Male; Microcirculation; Mononuclear Phagocyte System; Muscle Contraction; Muscle, Smooth, Vascular; Oxytocin; Phagocytosis; Rats; Rats, Brattleboro; Rats, Inbred Strains; Rats, Mutant Strains; Shock; Vasopressins; Wounds and Injuries

Topics: Angiography; Arteriovenous Malformations; Catheterization; Embolization, Therapeutic; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Neoplasms; Regional Blood Flow; Vasopressins; Wounds and Injuries

A metabolic conflict occurs between increased production of easily used substrates and inhibition of their metabolism in any injured animal. The terms ebb and flow describe the dwindling and rising tides of such activity. The ebb may last 24 to 72 hours; the flow is usually over within two weeks but may last up to eight weeks or longer in more severe cases. The ebb phase corresponds to the traumatic and initial post-traumatic period when there usually is adequate substrate (oxygen, glucose, fatty acid) to meet the diminished demand of the tissues. The flow phase is the period of convalescence. The object of the organism's initial defense following injury seems to stabilize the situation during the ebb phase (preservation of the internal milieu). The longer the ebb phase can be maintained and the more substrates that can be conserved, the more likely the animal will recover during the flow phase. The ebb phase is set in motion by an injury such as hemorrhage, burns, fractures, soft tissue damage by crushing sepsis, or diarrhea. After the ebb phase, a variable, integrated response of nervous, endocrine, and metabolic systems begins, which compromises normal function to achieve specific survival objectives (that is, protection, stabilization and adaptation). Systemic changes (such as tissue catabolism) devoted to caloric needs and local growth (that is, wound repair) are all directed at the ultimate objective of survival.

Topics: Animals; Cat Diseases; Cats; Diuresis; Dog Diseases; Dogs; Energy Metabolism; Glycogen; Homeostasis; Hydrocortisone; Muscles; Nitrogen; Oxygen Consumption; Vascular Resistance; Vasopressins; Wounds and Injuries

Topics: Adrenal Glands; Adrenocorticotropic Hormone; Adult; Aldosterone; Angiotensin II; Catecholamines; Child; Endocrine Glands; Glucagon; Growth Hormone; Humans; Hydrocortisone; Insulin; Pituitary Gland; Pituitary Gland, Posterior; Renin; Surgical Procedures, Operative; Thyrotropin; Vasopressins; Wounds and Injuries

We previously found that regardless of the animal injury model used resuscitation strategies that minimize fluid administration requirements lead to better outcomes. We hypothesized that a resuscitation regimen that limited the total volume of fluid administered would reduce morbidity and mortality rates in critically ill trauma patients.. We performed a double-blind randomized trial to assess the safety and efficacy of adding vasopressin to resuscitative fluid. Subjects were hypotensive adults who had sustained acute traumatic injury. Subjects were given fluid alone (control group) or fluid plus vasopressin (experimental group), first as a bolus (4 IU) and then as an intravenous infusion of 200 ml/h (vasopressin 2.4 IU/h) for 5 h.. We randomly assigned 78 patients to the experimental group (n=38) or the control group (n=40). The groups were similar in age, sex, preexisting medical illnesses, and mechanism and severity of injury. Serum vasopressin concentrations were higher in the experimental group than in the control group at admission, after infusion of vasopressin (p=0.01), and 12 h later. The experimental group required a significantly lower total volume of resuscitation fluid over 5 days than did the control group (p=0.04). The mortality rate at 5 days was 13% in the experimental group and 25% in the control group (p=0.19). The rates of adverse events, organ dysfunction, and 30-day mortality were similar.. This is the first trial to investigate the impact of vasopressin administration in trauma patients. Infusion of low-dose vasopressin maintained elevated serum vasopressin levels and decreased fluid requirements after injury.

Topics: Double-Blind Method; Female; Fluid Therapy; Humans; Male; Middle Aged; Prospective Studies; Resuscitation; Vasoconstrictor Agents; Vasopressins; Wounds and Injuries

While fluid management is established in controlled hemorrhagic shock, its use in uncontrolled hemorrhagic shock is being controversially discussed, because it may worsen bleeding. In the irreversible phase of hemorrhagic shock that was unresponsive to volume replacement, airway management and catecholamines, vasopressin was beneficial due to an increase in arterial blood pressure, shift of blood away from a subdiaphragmatic bleeding site towards the heart and brain and decrease of fluid resuscitation requirements. The purpose of this multicenter, randomized, controlled, international trial is to assess the effects of vasopressin (10 IU IV) vs. saline placebo IV (up to 3 injections at least 5 min apart) in patients with prehospital traumatic hemorrhagic shock that persists despite standard shock treatment. The study will be carried out by helicopter emergency medical service teams in Austria, Germany, Czech Republic, Portugal, the Netherlands and Switzerland. Inclusion criteria are adult trauma patients with presumed traumatic hemorrhagic shock (systolic arterial blood pressure <90 mmHg) that does not respond to the first 10 min of standard shock treatment (endotracheal intubation, fluid resuscitation and use of vasopressors) after arrival of the first emergency physician at the scene. The time window for randomization will close after 30 min of shock treatment. Exclusion criteria are terminal illness, no intravenous access, age <18 years, injury >60 min before randomization, cardiac arrest before randomization, presence of a do-not-resuscitate order, untreated tension pneumothorax, untreated cardiac tamponade, or known pregnancy. Primary study end-point is the hospital admission rate, secondary end-points are hemodynamic variables, fluid resuscitation requirements and hospital discharge rate.

Topics: Air Ambulances; Blood Pressure; Double-Blind Method; Emergency Medical Services; Endpoint Determination; Humans; Resuscitation Orders; Shock, Hemorrhagic; Vasoconstrictor Agents; Vasopressins; Wounds and Injuries

The endocrine stress response under inhalation anesthesia with halothane, enflurane, and isoflurane was investigated in 30 patients during and after orthopedic surgery (Table 2). Plasma levels of adrenaline and noradrenaline (by HPLC/ECD), ADH, ACTH, and cortisol (by RIA), glucose, lactate, and free glycerol were determined before induction of anesthesia, 10 min after intubation, 10 min before the end of the operation, and 5 and 30 min after extubation. Statistical evaluation was undertaken by analysis of variance with repeated measures on one factor. P values of less than 0.05 were considered significant. There were no significant differences in the concentrations of plasma catecholamines (Table 4, Figs. 1 and 2), ADH, ACTH (Table 5, Figs. 3 and 4), or cortisol before and during surgery between the groups. ADH was lower in the halothane group 5 and 30 min after extubation (P = 0.05), which might be due to the prolonged elimination of halothane after anesthesia. Blood pressure, heart rate (Table 3), and plasma concentrations of glucose, lactate, and free glycerol (Table 6) were comparable in all groups. It is concluded that for clinical practice halothane, enflurane, and isoflurane are comparable in their influence on the surgical stress response.

Topics: Adrenocorticotropic Hormone; Adult; Anesthesia, Inhalation; Energy Metabolism; Enflurane; Epinephrine; Halothane; Hormones; Humans; Hydrocortisone; Isoflurane; Middle Aged; Norepinephrine; Stress, Physiological; Vasopressins; Wounds and Injuries

Hypopituitarism after hypovolemic shock is well established in certain patient cohorts. However; the effects of hemorrhagic shock on pituitary function in trauma patients remains unknown. The aim of this study was to assess pituitary hormone variations in trauma patients with hemorrhagic shock.. Patients with acute traumatic hemorrhagic shock presenting to our level 1 trauma center were prospectively enrolled. Hemorrhagic shock was defined as systolic blood pressure (SBP) ≤ 90 mmHg on arrival or within 10 minutes of arrival in the emergency department, and requirement of ≥2 units of packed red blood cell transfusion. Serum cortisol and serum pituitary hormones (vasopressin [ADH], adrenocorticotrophic hormone [ACTH], thyroid stimulating hormone [TSH], follicular stimulating hormone [FSH], and luteinizing hormone [LH]) were measured in each patient on admission and at 24, 48, 72, and 96 hours after admission. Outcome measure was variation in pituitary hormones.. A total of 42 patients were prospectively enrolled; mean age was 37 ± 12 years, mean SBP 85.4 ± 64.5 mmHg, and median Injury Severity Score was 26 (range 18 to 38). There was an increase in the levels of cortisol (p < 0.001), a decrease in the levels of ACTH (p < 0.001) and ADH (p < 0.001), but no change in the levels of LH (p = 0.30), FSH (p = 0.07), and TSH (p = 0.89) over 96 hours. Ten patients died during their hospital stay. Patients who died had higher mean admission ADH levels (p = 0.03), higher mean admission ACTH levels (p < 0.001), and lower mean admission cortisol levels (p = 0.04) compared with patients who survived.. Acute hypopituitarism does not occur in trauma patients with acute hemorrhagic shock. In patients who died, there was a decrease in cortisol levels, which appears to be adrenal in origin.

Topics: Acute Disease; Adrenocorticotropic Hormone; Adult; Aged; Biomarkers; Female; Humans; Hydrocortisone; Hypopituitarism; Luteinizing Hormone; Male; Middle Aged; Prospective Studies; Shock, Hemorrhagic; Thyrotropin; Vasopressins; Wounds and Injuries

The stress response to surgery, critical illness, trauma, and burns encompasses derangements of metabolic and physiological processes that induce perturbations in the inflammatory, acute phase, hormonal, and genomic responses. Hypermetabolism and hypercatabolism result, leading to muscle wasting, impaired immune function and wound healing, organ failure, and death. The surgery-induced stress response is largely similar to that triggered by traumatic injuries; the duration of the stress response, however, varies according to the severity of injury (surgical or traumatic). This spectrum of injuries and insults ranges from small lacerations to severe insults such as large poly-traumatic and burn injuries. Burn injuries provide an extreme model of trauma induced stress responses that can be used to study the long-term effects of a prolonged stress response. Although the stress response to acute trauma evolved to confer improved chances of survival following injury, in modern surgical practice the stress response can be detrimental.

Topics: Burns; Critical Illness; Growth Hormone; Humans; Hydrocortisone; Inflammation; Muscular Diseases; Stress, Physiological; Surgical Procedures, Operative; Vasopressins; Wound Healing; Wounds and Injuries

We sought to perform the first characterization of vasopressin and other vasoactive mediators released during resuscitation of hypotensive trauma patients.. This institutional review board-approved study was conducted under waiver of consent. Adults with clinical evidence of acute traumatic injury and systolic blood pressure less than or equal to 90 mm Hg within 1 hour of arrival were evaluated at our Level I trauma center. Two hundred three patients were screened with 50 enrolled from February 2010 to February 2011. Demographic information was also collected. Blood samples were obtained at 0, 30, 60, 90, 120, and 240 minutes after arrival, and assays were performed for vasopressin, angiotensin II, epinephrine, and cortisol. We assessed the significance of variation in these vasoactive mediators with injury and transfusion of more than 600 mL, with adjustment for time using repeated-measures linear models in log units.. We found that vasopressin (p = 0.005) and epinephrine (p = 0.01) increased significantly with injury, while angiotensin (p = 0.60) and cortisol (p = 0.46) did not and that vasopressin (p < 0.001) and epinephrine (p = 0.004) increased significantly in patients requiring transfusion of more than 600 mL but angiotensin II (p = 0.11) and cortisol (p = 0.90) did not. Relatively low levels of vasopressin (<30 pg/mL) were observed at least once during the first 2 hours in 88% of trauma patients, and abnormally low epinephrine levels (<100 pg/mL) were observed at least once during the first 2 hours in 18% of trauma patients.. This is the first clinical trial to serially evaluate vasopressin and other vasoactive mediators following trauma during the resuscitation phase. Vasopressin, in particular, and epinephrine seem to be the key mediators produced in the human response to severe injury. A deficiency of vasopressin may contribute to intractable shock after trauma.. Prognostic/epidemiologic study, level III.

Topics: Adolescent; Adult; Aged; Angiotensin II; Blood Pressure; Child; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Epinephrine; Female; Humans; Hydrocortisone; Hypotension; Infant; Injury Severity Score; Male; Middle Aged; Resuscitation; Time Factors; Vasopressins; Wounds and Injuries; Young Adult

Topics: Central Venous Pressure; Fluid Therapy; Humans; Infusions, Intravenous; Selection Bias; Shock, Hemorrhagic; Vasoconstrictor Agents; Vasopressins; Wounds and Injuries

Resuscitation of patients in hemorrhagic shock remains one of the most challenging aspects of trauma care. We showed in experimental studies that vasopressin, but not fluid resuscitation, enabled short-term and long-term survival in a porcine model of uncontrolled hemorrhagic shock after penetrating liver trauma. In this case report, we present two cases with temporarily successful cardiopulmonary resuscitation (CPR) using vasopressin and catecholamines in uncontrolled hemorrhagic shock with subsequent cardiac arrest that was refractory to catecholamines and fluid replacement. In a third patient, an infusion of vasopressin was started before cardiac arrest occurred; in this case, we were able to stabilize blood pressure thus allowing further therapy. The patient underwent multiple surgical procedures, developed multi-organ failure, but was finally discharged from the critical care unit without neurological damage.

Topics: Abdominal Injuries; Accidental Falls; Accidents, Traffic; Adult; Aged; Cardiopulmonary Resuscitation; Female; Heart Arrest; Humans; Male; Multiple Organ Failure; Shock, Hemorrhagic; Vasoconstrictor Agents; Vasopressins; Wounds and Injuries; Wounds, Stab

Topics: Catecholamines; Diaphragm; Hemorrhage; Humans; Perfusion; Regional Blood Flow; Shock, Hemorrhagic; Vasoconstrictor Agents; Vasopressins; Wounds and Injuries

Continuous pump-driven veno-venous hemofiltration (CVVH) has become an established method for treatment of acute renal failure (ARF). Since severe disturbances of (micro-) circulation are intimately involved in the bad outcome of these patients, the profile of endocrinological regulators of circulation was prospectively and serially measured in patients undergoing pump-driven CVVH (n = 15). 15 patients with similar APACHE II score, but without ARF and without CVVH were also studied. Endothelin-1 (ET-1), atrial natriuretic peptide (ANP), vasopressin, renin, and catecholamine (epinephrine, norepinephrine) plasma levels were measured before start of CVVH (= "baseline") (in the non-CVVH patients: admission to intensive care unit) and during the next 5 days. Various hemodynamic parameters were additionally monitored. MAP, HR, PAP, CI, and right ventricular hemodynamics (RVEF, RVEDV, RVESV) remained almost unchanged in the CVVH patients and were without differences to the non-CVVH group within the entire investigation period. PCWP and RAP were higher in the CVVH patients already at baseline (RAP, 17.8 +/- 4.0 mmHg; PCWP, 22.1 +/- 4.5 mmHg) (p < .02) and remained elevated in the further course of the investigation. Renin plasma level was higher already at baseline in the CVVH patients (907 +/- 184 pg/ml) (p < .05) and further increased during CVVH (to 1453 +/- 186 pg/mL). Vasopressin increased only in the CVVH group (from 3.80 +/- .66 to 11.85 +/- 1.05 pg/mL) (p < .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Kidney Injury; Atrial Natriuretic Factor; Blood Circulation; Blood Pressure; Creatinine; Dopamine; Endothelins; Epinephrine; Female; Hemodynamics; Hemofiltration; Humans; Lactates; Lactic Acid; Male; Middle Aged; Norepinephrine; Renin; Sepsis; Time Factors; Vascular Resistance; Vasopressins; Wounds and Injuries

Two patients with post-traumatic diabetes insipidus (DI) are reported. One had suffered a fatal injury and the other a mild contusion without amnesia before DI developed. These two instances exemplify the wide spectrum of post-traumatic DI and, hence, the importance of ruling out DI even afer a mild closed-head injury.

Topics: Adult; Central Nervous System; Deamino Arginine Vasopressin; Diabetes Insipidus; Diuresis; Female; Humans; Male; Middle Aged; Vasopressins; Wounds and Injuries

The neuroendocrine and substrate responses immediately after injury have been extensively investigated in man and animals. The purpose of the present study was to examine simultaneously, the temporal, metabolic and endocrine consequences of a single uniform injury induced by the injection of lambda-carrageenan into the hindlimbs of male Sprague-Dawley rats and to compare this response to that observed in semistarved pair-fed control animals. Immediately after injury there was a decrease in the plasma hematocrit, increase in tissue water and peripheral vasoconstriction that suggested hypovolemia. This was followed by a restoration of the blood volume by 1 day as reflected in hemodilution. Alterations in insulin, glucagon, ACTH, corticosterone, epinephrine, norepinephrine, and dopamine in wounded animals occurred during the first 5 days. However, similar changes were observed in pair-fed control animals from days 1 to 5. These findings implied that the early endocrine response observed from 0 to 24 hours after injury arises, primarily as a result of hypovolemia, whereas the response observed from 1 to 5 days appeared to be the result of semistarvation. In contrast to the endocrine alterations observed, alterations in the plasma concentrations of lactate, acetoacetate and beta-hydroxybutyrate persisted for up to 15 days. The presence of these substrate alterations in the absence of hormonal stimuli suggest that nonendocrine mechanisms exist to induce these alterations. The possibility is raised that these substrate alterations may be, at least in part, the result of the inflammatory infiltrate.

Topics: 3-Hydroxybutyric Acid; Acetoacetates; Adrenocorticotropic Hormone; Animals; Blood Glucose; Body Water; Carrageenan; Catecholamines; Corticosterone; Fatty Acids, Nonesterified; Food Deprivation; Glucagon; Hematocrit; Hormones; Hydroxybutyrates; Insulin; Lactates; Male; Osmolar Concentration; Rats; Rats, Inbred Strains; Triglycerides; Vasopressins; Wounds and Injuries

We had previously shown that the hypothalamo-neurohypophyseal vasopressin secreting system is suppressed in aged rats. In the present study, using aged (26 months) male Fischer 344 (F344) rats, we showed that in contrast to vasopressin, oxytocin plasma concentration and hypothalamic content were unaltered in comparison with young (2-3 months) rats; however, based on data from our past and current studies, the neurohypophyseal concentrations of both hormones were found to be decreased in aged rats. We also compared the effect of aging on the oxytocin and vasopressin in secretory functions. Superfusion technique was employed to examine oxytocin and vasopressin release from isolated neural lobes of young (2-3 months) and old (26 months) male F344 and young (2-3 months), middle-aged (12 months) and old (30 months) Sprague-Dawley (SD) rats. Aging affected basal release of oxytocin and vasopressin in a differential manner. Expressed per gland, basal release of oxytocin increased in aged rats of both strains; whereas vasopressin release decreased in SD, and did not change in F344, old rats. The vasopressin responses to electrical stimulation, 56 mM K+ and initial traumatic release were decreased in aged rats; whereas oxytocin responses were either unaltered or decreased much less. All age-related changes were more pronounced in SD than in F344 rats. Thus, while the aging process is associated with a significant impairment in the vasopressin secretory function, the oxytocin secretory function is much less affected by that process. Significant strain differences were observed in the effects of aging on oxytocin and vasopressin release.

Topics: Aging; Animals; Electric Stimulation; Hypothalamus; Male; Oxytocin; Pituitary Gland, Posterior; Rats; Rats, Inbred F344; Rats, Inbred Strains; Vasopressins; Wounds and Injuries

The opioid peptide endorphins, enkephalins, and dynorphins--found in brain, pituitary, and gut--are neurohormones involved in the regulation of a number of seemingly diverse biologic activities, including respiration, mood, pain perception, blood pressure, body temperature, and certain visceral responses. When viewed in integrated fashion, however, the spectrum of activities induced by the administration of both the exogenous opiates (e.g. morphine) and the endogenous opioids resembles a natural physiologic state: the sleep state. We propose that the opioid peptides in conjunction with the peptide neurohormone vasopressin are involved in the induction and maintenance of the sleep state. We also propose that the function of sleep is to protect an animal during periods when it is at a selective disadvantage, and we provide evidence to support and integrate both concepts.

Topics: Adaptation, Biological; Adolescent; Animals; Circadian Rhythm; Endorphins; Female; Food Deprivation; Humans; Infant; Labor, Obstetric; Male; Physical Exertion; Pregnancy; Sleep; Suprachiasmatic Nucleus; Vasopressins; Wounds and Injuries

The gastric incisions of rabbits intra-arterially infused with vasopressin were analyzed for collagen synthesis, tensile strength and inflammatory reaction for five, ten and 20 days from the time of wounding. Significant differences were looked for in the collagen content of treated and untreated wounds. Tensile strength of a strip of gastric wound with sutures removed was tested on a motor driven tensiometer. The breaking point of the strip in grams of weight required was used as the end point. A portion of tissue from the wound site of each of the 36 rabbits was processed for microscopic examination, and the resulting slides were labeled with code numbers to preserve blind conditions. The effect of vasopressin on the healing of a standard gastric incision in the rabbit was studied. When compared with those rabbits in the control study which were infused with a saline solution alone, no significant difference was found in tensile strength, inflammatory response or synthesis of new collagen, as determined by the hydroxyproline ratio. There would appear to be no adverse effects upon gastric wound healing as a result of intra-arterially infused vasopressin in the concentrations used in this experiment.

Topics: Animals; Collagen; Female; Inflammation; Male; Rabbits; Stomach; Tensile Strength; Vasopressins; Wound Healing; Wounds and Injuries

Topics: Animals; Antacids; Burns; Central Nervous System Diseases; Humans; Peptic Ulcer; Postoperative Complications; Stomach Ulcer; Stress, Physiological; Vasopressins; Wounds and Injuries

Topics: 17-Hydroxycorticosteroids; Acetylcholine; Adrenocorticotropic Hormone; Albuminuria; Aldosterone; Growth Hormone; Histamine; Humans; Hydrocortisone; Insulin; Neurons, Afferent; Oxygen Consumption; Postoperative Complications; Renin; Serotonin; Testosterone; Thyroid Hormones; Vasopressins; Wounds and Injuries

Topics: Antacids; Diagnosis, Differential; Humans; Stomach Ulcer; Stress, Physiological; Ulcer; Vasopressins; Wounds and Injuries

Topics: Aldosterone; Carbohydrate Metabolism; Catecholamines; Cell Membrane Permeability; Cortisone; Fatty Acids, Nonesterified; Glycogen; Humans; Insulin; Kidney; Lipid Metabolism; Osmolar Concentration; Proteins; Triglycerides; Urea; Vasopressins; Water-Electrolyte Balance; Wounds and Injuries

Topics: Adult; Angiography; Contrast Media; Foot; Gastrointestinal Hemorrhage; Humans; Injections, Intra-Arterial; Intestine, Small; Ischemia; Male; Mesenteric Arteries; Vasopressins; Wounds and Injuries

Topics: Animals; Cardiac Surgical Procedures; Dogs; Female; Humans; Male; Vasopressins; Wounds and Injuries

Topics: Animals; Diuresis; Dogs; Hemorrhage; Monitoring, Physiologic; Pain; Vasopressins; Wounds and Injuries

Topics: Animals; Body Fluids; Diabetes Insipidus; Dog Diseases; Dogs; Pharmacology; Urine; Vasopressins; Wounds and Injuries

Topics: Adolescent; Arginine Vasopressin; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Drug Therapy; Humans; Hydrochlorothiazide; Spironolactone; Vasopressins; Wounds and Injuries

Topics: Electrolytes; Potassium; Sodium; Vasopressins; Water-Electrolyte Balance; Wounds and Injuries

Topics: Brain; Brain Injuries; Diabetes Insipidus; Humans; Vasopressins; Wounds and Injuries

Topics: Arginine Vasopressin; Epinephrine; Heart; Heart Injuries; Heart, Artificial; Humans; Vasopressins; Wounds and Injuries