Prevention and Reversal of Myocardial Failure in Endotoxin Shock.
OKLAHOMA UNIV MEDICAL CENTER OKLAHOMA CITY
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The purpose of the study was to explore possible beneficial effects of digoxin and atropine on the myocardium, both utilized prior to the development of failure and during the later phase of chock when myocardial dysfunction is present. Heart donor dogs were administered an LD70E. coli endotoxin, and early and late treatments of digoxin and atropine were explored by comparing performance curves of the isolated working heart model exchanging blood with an intact support animal. Digoxin both prevented the precipitation of heart failure when administered early after endotoxin less than one hour and reversed the failure when used 5-7 hours following endotoxin injection. The treatments are notable in that they improved nyocardial performance and permitted longer survival of the heart preparation. Oxygen uptake, at a given afterload and cardiac output, was decreased or changed minimally from values in the failing state, thus demonstrating increased cardiac efficiency after treatment. Atropine administration did not appear to yield any significant degree of myocardial improvement, suggesting an absence of a myocardial depressant role of the parasympathetic nervous system. Author
- Anatomy and Physiology