October 26, 2007AJP Heart and Circulatory Physiology
Direct and reflexive effects of nitric oxide synthase inhibition on blood pressure
Why the study?
Does nitric oxide synthase inhibition with L-NAME affect blood pressure and sympathetic outflow differently in individuals with tetraplegia compared to intact controls?
Population
14 individuals (7 with tetraplegia and 7 age-matched neurologically intact controls)
Comparison
Nitro-L-arginine methyl ester intravenously over… vs Placebo intravenously over 60 min
Design
Other
Follow-up
up to 240 min post-infusion
Authors
Discussion
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Member takes
Implication
Greater pressor response to L-NAME in tetraplegia without NE suppression; leaves open whether sympathetic decentralization informs autonomic management.
Structured PICO
Does nitric oxide synthase inhibition with L-NAME affect blood pressure and sympathetic outflow differently in individuals with tetraplegia compared to intact controls?
P
Population
14 individuals (7 with tetraplegia and 7 age-matched neurologically intact controls)
I
Intervention
Nitro-L-arginine methyl ester (L-NAME) intravenously over 60 min at doses of 0.5, 1, 2, and 4 mg/kg
C
Comparator
Placebo (30 ml normal saline) intravenously over 60 min
O
Outcome
Mean arterial pressure, heart rate, and plasma norepinephrine concentrationssurrogate
Reflexive sympathoinhibition normally buffers the pressor response to nitric oxide synthase inhibition, an effect absent in tetraplegia due to decentralized sympathetic vasomotor control.
Cite This Study
Wecht et al. (2007) studied this question.