Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men
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Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men. / Sørensen, Henrik; Thomsen, J. H.; Meyer, A. S. Ps; Terzic, Dijana; Hilsted, L.; Kjærgaard, J.; Goetze, J. P.; Barbosa, Thales C; Secher, N. H.
I: Journal of Clinical Monitoring and Computing, Bind 31, Nr. 6, 12.2017, s. 1159–1166.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men
AU - Sørensen, Henrik
AU - Thomsen, J. H.
AU - Meyer, A. S. Ps
AU - Terzic, Dijana
AU - Hilsted, L.
AU - Kjærgaard, J.
AU - Goetze, J. P.
AU - Barbosa, Thales C
AU - Secher, N. H.
PY - 2017/12
Y1 - 2017/12
N2 - Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (SmO2) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined ± phenylephrine in males during supine rest (n = 17) and 40° HUT (n = 7). MAP, stroke volume (SV), heart rate (HR), and TPR were derived by Modelflow® and NIRS determined biceps SmO2 and (tibial) bone oxygenation (StibialO2). For ten subjects, cardiac filling and the diameter of the inferior caval vein (ICV collapsibility index: ((ICVexpiration − ICVinspiration)/ICVexpiration) × 100) were assessed by ultrasound. Pancreatic polypeptide (PP) and atrial natriuretic peptide (proANP) in plasma were determined by immunoassay. Brachial artery blood flow was assessed by ultrasound and skin oxygenation (SskinO2) monitored by white light spectroscopy. Phenylephrine increased MAP by 34% and TPR (62%; P < 0.001) during supine rest. The ICV collapsibility index decreased (24%; P < 0.001) indicating augmented cardiac preload although volume of the left atrium and ventricle did not change. SV increased (18%; P < 0.001) as HR decreased (24%; P < 0.001). ProANP increased by 9% (P = 0.002) with unaffected PP. Brachial artery blood flow tended to decrease while SskinO2 together with StibialO2 decreased by 11% (P = 0.026) and 20% (P < 0.001), respectively. Conversely, phenylephrine increased SmO2 (9%) and restored the HUT elicited decrease in SmO2 (by 19%) along with SV (P = 0.02). Phenylephrine reduces skin and bone oxygenation and tends to reduce arm blood flow, suggesting that the increase in SmO2 reflects veno-constriction with consequent centralization of the blood volume.
AB - Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (SmO2) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined ± phenylephrine in males during supine rest (n = 17) and 40° HUT (n = 7). MAP, stroke volume (SV), heart rate (HR), and TPR were derived by Modelflow® and NIRS determined biceps SmO2 and (tibial) bone oxygenation (StibialO2). For ten subjects, cardiac filling and the diameter of the inferior caval vein (ICV collapsibility index: ((ICVexpiration − ICVinspiration)/ICVexpiration) × 100) were assessed by ultrasound. Pancreatic polypeptide (PP) and atrial natriuretic peptide (proANP) in plasma were determined by immunoassay. Brachial artery blood flow was assessed by ultrasound and skin oxygenation (SskinO2) monitored by white light spectroscopy. Phenylephrine increased MAP by 34% and TPR (62%; P < 0.001) during supine rest. The ICV collapsibility index decreased (24%; P < 0.001) indicating augmented cardiac preload although volume of the left atrium and ventricle did not change. SV increased (18%; P < 0.001) as HR decreased (24%; P < 0.001). ProANP increased by 9% (P = 0.002) with unaffected PP. Brachial artery blood flow tended to decrease while SskinO2 together with StibialO2 decreased by 11% (P = 0.026) and 20% (P < 0.001), respectively. Conversely, phenylephrine increased SmO2 (9%) and restored the HUT elicited decrease in SmO2 (by 19%) along with SV (P = 0.02). Phenylephrine reduces skin and bone oxygenation and tends to reduce arm blood flow, suggesting that the increase in SmO2 reflects veno-constriction with consequent centralization of the blood volume.
KW - Atrial natriuretic peptide
KW - Muscle oxygenation
KW - Near infrared spectroscopy
KW - Pancreatic polypeptide
KW - Phenylephrine
KW - Skin oxygenation
KW - Tibial bone oxygenation
U2 - 10.1007/s10877-016-9965-y
DO - 10.1007/s10877-016-9965-y
M3 - Journal article
C2 - 27987104
AN - SCOPUS:85006416085
VL - 31
SP - 1159
EP - 1166
JO - Journal of Clinical Monitoring and Computing
JF - Journal of Clinical Monitoring and Computing
SN - 1387-1307
IS - 6
ER -
ID: 179281704