Does the Inhibitor of Nitric Oxide Synthase Improve Hemodynamics and Oxygen Metabolism in Hemorrhagic Hypotension?

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We measured hemodynamic and blood gas data to determine oxygen metabolism after administration of nitric oxide (NO) precursor, L-arginine (L-arg), and the inhibitor of NO synthase, L-NAME to dogs during hemorrhagic shock which was induced by 35 ml/kg blood exsanguination under isoflurane anesthesia. Hemodynamic data and blood gas analysis showed that L-arg increased cardiac index (CI), but decreased mean arterial pressure (MAP) and systemic vascular resistance index (SVRI) while the oxygen metabolism was not significantly altered in both the non-hemorrhagic and hemorrhagic periods. Following the administration of L-NAME during hemorrhagic hypotension, MAP returned to control values ; however, CI and oxygen delivery index (DO_2I) decreased significantly. Oxygen consumption index (VO_2I) did not change after L-NAME administration and pulmonary hemodynamics also did not change after L-arg and L-NAME administration. These data suggest the usage of NO synthase inhibitor may be therapeutic during hemorrhagic hypotension. Although L-arg increased CI, it did not increase DO_2I significantly. Therefore, we did not demonstrate the advantage of L-arg administration during hemorrhagic hypotension.
北里大学の論文
1996-08-31