Combined therapy of experimental endotoxin shock in monkeys.
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Biomedical subjects
Publications and source records attributed to V Trcka.
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The course and therapy of endotoxin shock were studied in 34 monkeys Macaca mulatta. E. coli endotoxin was infused intravenously to conscious animals. The individual responses to a dose of 3 mg . kg-1 exhibited a considerable variability. A part of shocked animals were successfully rescued by a combined infusion of dopamine, hydrocortisone, and dextran; untreated animals died of endotoxin shock. Morphological changes in their parenchymatous organs were little marked in the acute experiment.
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In our study of experimental endotoxin shock we tried therapeutic control of reversible acute endotoxin shock. In a standard model in the dog, in which endotoxin shock had been induced by intravenous injection of E. coli endotoxin dosed 1.75 mg/kg, the effects of hydrocortisone and dopamine administered concurrently were investigated. It was found that endotoxin shock elicited primarily haemodynamic alterations; arterial hypotension, reduction of renal arterial blood flow, elevation of central venous flow, decrease in left ventricular pressure, and vasodilatation. Dopamine plus hydrocortisone prevented development of alterations, primarily of haemodynamic ones, already in the initial phase of shock. Dopamine plus hydrocortisone raised the survival quota of animals in endotoxin shock, enhanced the renal arterial blood flow, maintained the diuresis, enhanced myocardial contractility, and elevated left ventricular blood pressure. After higher dosages of dopamine the peripheral blood pressure rose as well. The dosage of dopamine has to be adjusted with respect to the actual state of haemodynamics. The developing tendency to acidosis was not brought under control within the three-hour monitoring period.
The fall in the ventricular fibrillation threshold during the first half an hour following ligation of the descending branch of the left coronary artery in dog was not influenced by the i.v. injection of trimecain (Mesokain Spofa). On the other hand, an i.v. injection of methypranol (Trimepranol Spofa) given prior to ligation increased the level of ventricular fibrillation threshold 3 to 4 times compared to control value before occlusion in all 10 studied dogs. Depression of the beta-blocking adrenergic activity may thus prevent the occurrence of ventricular fibrillation in acute myocardial ischaemia.
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