Comparative effects of dopamine, naloxone, and prostacyclin in the resuscitation of fecal-Escherichia coli peritonitis-induced septic shock in neonatal swine

Thom E. Lobe, Eric D. Dobkin, Dennis Gore, Jatinder J Bhatia, Hugo A. Linares, Daniel L. Traber

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

To explain the high neonatal mortality from peritonitis-induced septic shock despite current resuscitation practices, the efficacy of dopamine, naloxone, and prostacyclin was evaluated in an experimental neonatal model. Hemodynamics were monitored ans survival was measured in anesthetized neonatal swine, which were subjected to fatal fecal-Escherichia coli peritonitis-induced septic shock. All the animals received fluid resuscitation, antibiotics, and bicarbonate to correct acidosis. Pharmacologic resuscitation began when cardiac output dropped below baseline in the experimental groups. Although significant differences were observed between groups in cardiac output, mean arterial and mean pulmonary arterial pressures, left ventricular stroke work, stroke volume, and pulmonary vascular resistance indicies (P<0.02), and each animal exhibited favorable hemodynamic responses during the first several hours of dopamine and naloxone infusion, these drugs failed to prolong survival. Also, 5 of the 9 naloxone-treated pigs (56%), died with histologically proven intestinal ischemia (P<0.02). Thus, dopamine, naloxone, and prostacyclin (at doses commonly recommended for the treatment of septic shock) fail to positively infuence the fatal course of this condition, and the use of naloxone in this model is associated with profound intestinal ischemia.

Original languageEnglish (US)
Pages (from-to)539-544
Number of pages6
JournalJournal of Pediatric Surgery
Volume21
Issue number6
DOIs
StatePublished - Jan 1 1986
Externally publishedYes

Fingerprint

Epoprostenol
Septic Shock
Naloxone
Peritonitis
Resuscitation
Dopamine
Swine
Escherichia coli
Cardiac Output
Ischemia
Hemodynamics
Infant Mortality
Bicarbonates
Acidosis
Vascular Resistance
Stroke Volume
Arterial Pressure
Theoretical Models
Stroke
Anti-Bacterial Agents

Keywords

  • Septic shock
  • dopamine
  • eicosanoids
  • naloxone
  • opiate antagonists
  • peritonitis
  • prostacyclin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Comparative effects of dopamine, naloxone, and prostacyclin in the resuscitation of fecal-Escherichia coli peritonitis-induced septic shock in neonatal swine. / Lobe, Thom E.; Dobkin, Eric D.; Gore, Dennis; Bhatia, Jatinder J; Linares, Hugo A.; Traber, Daniel L.

In: Journal of Pediatric Surgery, Vol. 21, No. 6, 01.01.1986, p. 539-544.

Research output: Contribution to journalArticle

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abstract = "To explain the high neonatal mortality from peritonitis-induced septic shock despite current resuscitation practices, the efficacy of dopamine, naloxone, and prostacyclin was evaluated in an experimental neonatal model. Hemodynamics were monitored ans survival was measured in anesthetized neonatal swine, which were subjected to fatal fecal-Escherichia coli peritonitis-induced septic shock. All the animals received fluid resuscitation, antibiotics, and bicarbonate to correct acidosis. Pharmacologic resuscitation began when cardiac output dropped below baseline in the experimental groups. Although significant differences were observed between groups in cardiac output, mean arterial and mean pulmonary arterial pressures, left ventricular stroke work, stroke volume, and pulmonary vascular resistance indicies (P<0.02), and each animal exhibited favorable hemodynamic responses during the first several hours of dopamine and naloxone infusion, these drugs failed to prolong survival. Also, 5 of the 9 naloxone-treated pigs (56{\%}), died with histologically proven intestinal ischemia (P<0.02). Thus, dopamine, naloxone, and prostacyclin (at doses commonly recommended for the treatment of septic shock) fail to positively infuence the fatal course of this condition, and the use of naloxone in this model is associated with profound intestinal ischemia.",
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