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Gut and sublingual microvascular effect of esmolol during septic shock in a porcine model

Overview of attention for article published in Critical Care, December 2015
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Title
Gut and sublingual microvascular effect of esmolol during septic shock in a porcine model
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0960-3
Pubmed ID
Authors

Matthias Jacquet-Lagrèze, Bernard Allaouchiche, Damien Restagno, Christian Paquet, Jean-Yves Ayoub, Jêrome Etienne, François Vandenesch, Olivier Dauwalder, Jeanne-Marie Bonnet, Stéphane Junot

Abstract

Esmolol may efficiently reduce heart rate (HR) and decrease mortality during septic shock. An improvement of microcirculation dissociated from its macrocirculatory effect is suspected to play a role. The present study investigates the effect of esmolol on gut and sublingual microcirculation in a resuscitated piglet model of septic shock. Fourteen piglets, anesthetized and mechanically ventilated, received a suspension of live Pseudomonas aeruginosa. They were randomly assigned to two groups: esmolol (E) group received an infusion of esmolol, started at 7.5 μg.kg(-1).min(-1), and progressively increased to achieve a HR below 90 beats · min(-1). Control (C) group received an infusion of Ringer's lactate solution. HR, mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), systemic vascular resistance (SVR), arterio-venous blood gas and lactate were recorded. Oxygen consumption (VO2), delivery (DO2) and peripheral extraction (O2ER) were computed. Following an ileostomy, a laser Doppler probe was applied on ileal mucosa to monitor gut microcirculation and laser Doppler flow (GMLDF). Videomicroscopy was also used on ileal mucosa and sublingual areas to evaluate mean flow index (MFI), heterogeneity, ratio of perfused villi (PV) and proportion of perfused vessels (PPV). Resuscitation maneuvers were performed following a defined algorithm. Bacterial infusion induced a significant alteration of the gut microcirculation with an increase in HR. Esmolol produced a significant time.group effect with a decrease in HR (p < 0.004) and an increase in SVR (p < 0.004). Time.group effect was not significant for CI and MAP, but there was a clear trend toward a decrease in CI and MAP in the E group. Time.group effect was not significant for SI, O2ER, DO2, VO2, GMLDF, and lactate. A significant time.group effect of ileal microcirculation was found with a lower ileal villi perfusion (p < 0.025) in the C group and a trend toward a better MFI in the E group. No difference between both groups was found regarding microcirculatory parameters in the sublingual area. Esmolol provided a maintenance of microcirculation, during sepsis despite its negative effects on macrocirculation. Some parameters even showed a trend toward an improvement of the microcirculation in the gut area in the esmolol group.

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X Demographics

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 63 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
France 1 2%
Germany 1 2%
Unknown 61 97%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 11 17%
Student > Master 8 13%
Researcher 5 8%
Student > Bachelor 5 8%
Professor 4 6%
Other 16 25%
Unknown 14 22%
Readers by discipline Count As %
Medicine and Dentistry 36 57%
Agricultural and Biological Sciences 3 5%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Biochemistry, Genetics and Molecular Biology 2 3%
Business, Management and Accounting 1 2%
Other 3 5%
Unknown 16 25%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 August 2015.
All research outputs
#20,656,161
of 25,374,647 outputs
Outputs from Critical Care
#5,970
of 6,554 outputs
Outputs of similar age
#291,517
of 395,408 outputs
Outputs of similar age from Critical Care
#460
of 466 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one is in the 10th percentile – i.e., 10% of other outputs scored the same or lower than it.
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We're also able to compare this research output to 466 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.