Effect of selective inhibition of renal inducible nitric oxide synthase on renal blood flow and function in experimental hyperdynamic sepsis*

Ken Ishikawa; Paolo Calzavacca; Rinaldo Bellomo; Michael Bailey; Clive N. May

doi:10.1097/ccm.0b013e3182514be9

May 23, 2012Critical Care Medicine

Effect of selective inhibition of renal inducible nitric oxide synthase on renal blood flow and function in experimental hyperdynamic sepsis*

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Key Points

To assess whether selective intrarenal inhibition of inducible nitric oxide synthase improves renal function and modulates elevated renal blood flow in hyperdynamic sepsis.
Conducted a prospective crossover randomized controlled interventional study in 12 unilaterally nephrectomized Merino ewes.
Administered 2-hour intrarenal infusions of a selective iNOS inhibitor (1400W), a partially selective inhibitor (aminoguanidine), or a nonselective inhibitor (L-NAME) following the induction of hyperdynamic sepsis.
Hyperdynamic sepsis reduced creatinine clearance from 32 to 16 mL/min (ratio 0.51, 95% CI [0.28–0.92]) despite an increase in renal blood flow from 241 to 343 mL/min (difference 102 mL/min, 95% CI [78–126]).
Infusion of 1400W did not alter renal blood flow, urine output, or creatinine clearance.
Infusion of L-NAME and high-dose aminoguanidine restored renal blood flow to baseline levels but did not alter creatinine clearance.

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Implication

Demonstrates that selective iNOS inhibition fails to restore kidney function in ovine hyperdynamic sepsis, suggesting other nitric oxide isoforms drive vasodilation.

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Ishikawa et al. (2012) studied this question.

synapsesocial.com/papers/6a93a5cf04d7c7946bb855a4 https://doi.org/10.1097/ccm.0b013e3182514be9

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Effect of selective inhibition of renal inducible nitric oxide synthase on renal blood flow and function in experimental hyperdynamic sepsis*

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Effect of selective inhibition of renal inducible nitric oxide synthase on renal blood flow and function in experimental hyperdynamic sepsis*

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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