The Effect of Endotoxin on General and Coronary Haemodynamics and Metabolism, and its Relation in Certain Infectious Diseases

  • G.M. Maxwell Department of Paediatrics, University of Adelaide, Adelaide Children’s Hospital, North Adelaide, 5006 South Australia.
Keywords: endotoxin, coronary flow, cardiac output, haemodynamics.

Abstract

Shock occurs in gram-negative septicaemia, dengue, and other infections: to understand the situation better, a study was made of the effects of endotoxin on the general and coronary circulation of intact animals. Cardiac output (Fick), coronary flow (N2O Fick), vascular pressures, glucose lactate, pyruvate, non-esterified fatty acid (NEFA), and C14 palmitate levels, were measured before and after the injection of Serratia marcescens endotoxin into healthy anaesthetized dogs.

Cardiac output, vascular pressures, and cardiac work fell precipitously. Coronary blood flow, myocardial O2 consumption, and cardiac efficiency decreased by 50%.

Whole-body glucose, lactate, pyruvate, and NEFA increased, but no change occurred in the myocardial extraction of these substances. The myocardial oxidation of C14 palmitate increased.

The general haemodynamic changes are similar to those occurring in patients; it is suggested that the changes in the coronary circulation seen in animals may also occur in the clinical situation. Other animal studies with a histamine releaser (Tween 20), gave results similar to those of endotoxin. Anaphylotoxins may then also be relevant to the "shock" state of certain infections.

References

BOKISH, V.A.; TO F.H. RUSSELL, P.K.; DIXON, F.J. and MULLEREBER HARD, H.J. : The potential pathogenic role of complement in dengue hemorrhagic shock syndrome. New Engl. J. Med. 289 : 996 (1973).

BURNELL, R.H. and MAXWELL, G.M.: General and coronary haemodynamic effects of Tween 20. Aust. J. exp. Biol. med. Sci. 52: 151 (1974).

EDWARDS, W.S.;REDER, W.E.; SIEGEL, A and BING, R.J. : Coronary blood flow and myocardial oxygen consumption in haemorrhagic shock. Surg. Forum 4: 505 (1953).

ENTWISLE, G. and HALE, E. : Hemodynamic alterations in hemorrhagic fever. Circ. 15 : 414 (1957).

MAXWELL, G.M. : The effect of induced water and salt loss upon the general and cardiac haemodynamics and metabolism of the intact dog. Clin. Sci. 30 : 29 (1966).

OBEYESEKERE, I. and HERMON, Y.: Myocarditis and cardiomyopathy after arbovirus infections (dengue and chikungunya fever). Br. Heart J. 34 : 821 (1972).

WONG HOCK BOON, ANG POON LIAT, VELLAYAPPAN, K. and ISMAIL, G. : Dengue haemorrhagic fever in children in Singapore in the 1973 outbreak. J. Singapore paediatr. Soc. 15: 46 (1973).
Published
2017-05-29
How to Cite
1.
Maxwell G. The Effect of Endotoxin on General and Coronary Haemodynamics and Metabolism, and its Relation in Certain Infectious Diseases. PI [Internet]. 29May2017 [cited 22Dec.2024];15(9-10):262-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1427
Received 2017-05-26
Accepted 2017-05-26
Published 2017-05-29