Effects of selective iNOS inhibition on gut and liver O2-exchange and energy metabolism during hyperdynamic porcine endotoxemia

Shock. 2001 Sep;16(3):203-10. doi: 10.1097/00024382-200116030-00006.

Abstract

We have previously demonstrated that non-selective nitric oxide synthase (NOS) inhibition did not reverse the LPS-induced deterioration of hepato-splanchnic energy status in porcine endotoxic shock. Therefore, this study investigated the effect of selective inducible NOS (iNOS) inhibition using 1400 W on intestinal and liver perfusion, O2 kinetics, and energy metabolism during hyperdynamic porcine endotoxemia. Intravenous E. Coli LPS was continuously infused over 24 h concomitant with fluid resuscitation. After 12 h of endotoxemia, continuous intravenous infusion of 1400 W was started until the end of the experiment and was titrated to maintain mean blood pressure (MAP) at baseline levels. Twelve, 18, and 24 h after starting LPS, we measured hepatic arterial and portal venous blood flow, ileal mucosal-arterial PCO2 gap, portal as well as hepatic venous lactate/pyruvate ratios, and endogenous glucose production rate. Expired NO and plasma nitrate levels were assessed as a measure of NO production. 1400 W decreased LPS-induced increase in expired NO and allowed for the maintenance of MAP without modification of cardiac output. Despite unchanged regional macrocirculation, 1400 W prevented the progressive rise of ileal mucosal-arterial PCO2 gap, significantly improved the LPS-induced impairment of hepato-splanchnic redox state, and blunted the decline in liver lactate clearance. Increased glucose production rate was not influenced. Thus, the selective iNOS inhibition with 1400 W prevented circulatory failure and largely attenuated otherwise progressive LPS-induced deterioration of intestinal and hepatocellular energy metabolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amidines / pharmacology
  • Animals
  • Benzylamines / pharmacology
  • Digestive System / drug effects
  • Digestive System / metabolism*
  • Endotoxemia / drug therapy
  • Endotoxemia / metabolism*
  • Endotoxemia / physiopathology
  • Energy Metabolism / drug effects
  • Enzyme Inhibitors / pharmacology
  • Female
  • Hemodynamics
  • Intestinal Mucosa / metabolism
  • Intestines / drug effects
  • Liver / drug effects
  • Liver / metabolism*
  • Male
  • Nitric Oxide Synthase / antagonists & inhibitors*
  • Nitric Oxide Synthase / metabolism*
  • Nitric Oxide Synthase Type II
  • Oxygen / metabolism*
  • Perfusion
  • Swine

Substances

  • Amidines
  • Benzylamines
  • Enzyme Inhibitors
  • N-(3-(aminomethyl)benzyl)acetamidine
  • Nitric Oxide Synthase
  • Nitric Oxide Synthase Type II
  • Oxygen