Relationship between infusion rates, plasma concentrations, and cardiovascular and metabolic effects during the infusion of norepinephrine in healthy volunteers

OBJECTIVETo determine the relationship between iv infusion rate, plasma concentrations, and hemodynamic and metabolic actions of norepinephrine. DESIGNNorepinephrine was administered by using five iv infusion rates (0.01 to 0.2 μg/kg/min) for 30 mins each to eight volunteers, for the purpose of cons...

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Veröffentlicht in:Critical care medicine 1992-09, Vol.20 (9), p.1250-1256
Hauptverfasser: ENSINGER, HERMANN, STEIN, BERNHARD, JÄGER, OLIVER, GRÜNERT, ADOLF, AHNEFELD, FRIEDRICH W
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container_end_page 1256
container_issue 9
container_start_page 1250
container_title Critical care medicine
container_volume 20
creator ENSINGER, HERMANN
STEIN, BERNHARD
JÄGER, OLIVER
GRÜNERT, ADOLF
AHNEFELD, FRIEDRICH W
description OBJECTIVETo determine the relationship between iv infusion rate, plasma concentrations, and hemodynamic and metabolic actions of norepinephrine. DESIGNNorepinephrine was administered by using five iv infusion rates (0.01 to 0.2 μg/kg/min) for 30 mins each to eight volunteers, for the purpose of constructing cumulative plasma concentration-response curves. SETTINGLaboratory of the Department of Anesthesiology at a university hospital. MEASUREMENTS AND MAIN RESULTSSystolic and diastolic BP, heart rate, and the plasma concentrations of norepinephrine, glucose, non-esterified fatty acids, and insulin were measured at the end of each infusion rate. During the highest infusion rate, plasma norepinephrine concentrations increased from 199 ± 75 to 7475 ± 1071 pg/mL (1.18 ± 0.44 to 44.18 ± 6.33 nmol/L). Typical hemodynamic responses, such as increases in BP and decreases in heart rate, were seen, while the plasma concentrations of glucose and nonesterified fatty acids increased from 92 ± 10 to 132 ± 17 mg/dL (5.1 ± 0.6 to 7.3 ± 0.9 mmol/L) and 11 ± 4 to 34 ± 6 mg/dL (0.11 ± 0.04 to 0.34 ± 0.06 g/L), respectively, during the 0.2 μg/kg/min infusion rate (p
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DESIGNNorepinephrine was administered by using five iv infusion rates (0.01 to 0.2 μg/kg/min) for 30 mins each to eight volunteers, for the purpose of constructing cumulative plasma concentration-response curves. SETTINGLaboratory of the Department of Anesthesiology at a university hospital. MEASUREMENTS AND MAIN RESULTSSystolic and diastolic BP, heart rate, and the plasma concentrations of norepinephrine, glucose, non-esterified fatty acids, and insulin were measured at the end of each infusion rate. During the highest infusion rate, plasma norepinephrine concentrations increased from 199 ± 75 to 7475 ± 1071 pg/mL (1.18 ± 0.44 to 44.18 ± 6.33 nmol/L). Typical hemodynamic responses, such as increases in BP and decreases in heart rate, were seen, while the plasma concentrations of glucose and nonesterified fatty acids increased from 92 ± 10 to 132 ± 17 mg/dL (5.1 ± 0.6 to 7.3 ± 0.9 mmol/L) and 11 ± 4 to 34 ± 6 mg/dL (0.11 ± 0.04 to 0.34 ± 0.06 g/L), respectively, during the 0.2 μg/kg/min infusion rate (p &lt;.05). Despite the increase in glucose concentration, insulin remained at baseline values. Metabolic and hemodynamic effects occurred at similar plasma concentrations throughout the study. CONCLUSIONSAdministration of norepinephrine showed no selective hemodynamic actions. The metabolic responses observed in this investigation were similar to those responses seen during increased endogenous sympathetic nervous system activity, such as stress, exercise, or trauma.</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/00003246-199209000-00011</identifier><identifier>PMID: 1521439</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: Williams &amp; Wilkins</publisher><subject>Adult ; Analysis of Variance ; Biological and medical sciences ; Blood - drug effects ; Blood - metabolism ; Cardiotonic agents ; Cardiovascular system ; Cardiovascular System - drug effects ; Chromatography, High Pressure Liquid ; Dose-Response Relationship, Drug ; Hemodynamics - drug effects ; Humans ; Infusions, Intravenous - methods ; Male ; Medical sciences ; Norepinephrine - administration &amp; dosage ; Norepinephrine - blood ; Norepinephrine - pharmacology ; Pharmacology. Drug treatments ; Reference Values ; Regression Analysis ; Time Factors</subject><ispartof>Critical care medicine, 1992-09, Vol.20 (9), p.1250-1256</ispartof><rights>Williams &amp; Wilkins 1992. All Rights Reserved.</rights><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4791-35a55d89c86ff5bc7ec07dbd51436a48fe9ed8ab48a6ffb6a9e84f4b9480cfb3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=4310552$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1521439$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ENSINGER, HERMANN</creatorcontrib><creatorcontrib>STEIN, BERNHARD</creatorcontrib><creatorcontrib>JÄGER, OLIVER</creatorcontrib><creatorcontrib>GRÜNERT, ADOLF</creatorcontrib><creatorcontrib>AHNEFELD, FRIEDRICH W</creatorcontrib><title>Relationship between infusion rates, plasma concentrations, and cardiovascular and metabolic effects during the infusion of norepinephrine in healthy volunteers</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVETo determine the relationship between iv infusion rate, plasma concentrations, and hemodynamic and metabolic actions of norepinephrine. DESIGNNorepinephrine was administered by using five iv infusion rates (0.01 to 0.2 μg/kg/min) for 30 mins each to eight volunteers, for the purpose of constructing cumulative plasma concentration-response curves. SETTINGLaboratory of the Department of Anesthesiology at a university hospital. MEASUREMENTS AND MAIN RESULTSSystolic and diastolic BP, heart rate, and the plasma concentrations of norepinephrine, glucose, non-esterified fatty acids, and insulin were measured at the end of each infusion rate. During the highest infusion rate, plasma norepinephrine concentrations increased from 199 ± 75 to 7475 ± 1071 pg/mL (1.18 ± 0.44 to 44.18 ± 6.33 nmol/L). Typical hemodynamic responses, such as increases in BP and decreases in heart rate, were seen, while the plasma concentrations of glucose and nonesterified fatty acids increased from 92 ± 10 to 132 ± 17 mg/dL (5.1 ± 0.6 to 7.3 ± 0.9 mmol/L) and 11 ± 4 to 34 ± 6 mg/dL (0.11 ± 0.04 to 0.34 ± 0.06 g/L), respectively, during the 0.2 μg/kg/min infusion rate (p &lt;.05). Despite the increase in glucose concentration, insulin remained at baseline values. Metabolic and hemodynamic effects occurred at similar plasma concentrations throughout the study. CONCLUSIONSAdministration of norepinephrine showed no selective hemodynamic actions. The metabolic responses observed in this investigation were similar to those responses seen during increased endogenous sympathetic nervous system activity, such as stress, exercise, or trauma.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Blood - drug effects</subject><subject>Blood - metabolism</subject><subject>Cardiotonic agents</subject><subject>Cardiovascular system</subject><subject>Cardiovascular System - drug effects</subject><subject>Chromatography, High Pressure Liquid</subject><subject>Dose-Response Relationship, Drug</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Infusions, Intravenous - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Norepinephrine - administration &amp; dosage</subject><subject>Norepinephrine - blood</subject><subject>Norepinephrine - pharmacology</subject><subject>Pharmacology. 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Drug treatments</topic><topic>Reference Values</topic><topic>Regression Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ENSINGER, HERMANN</creatorcontrib><creatorcontrib>STEIN, BERNHARD</creatorcontrib><creatorcontrib>JÄGER, OLIVER</creatorcontrib><creatorcontrib>GRÜNERT, ADOLF</creatorcontrib><creatorcontrib>AHNEFELD, FRIEDRICH W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ENSINGER, HERMANN</au><au>STEIN, BERNHARD</au><au>JÄGER, OLIVER</au><au>GRÜNERT, ADOLF</au><au>AHNEFELD, FRIEDRICH W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between infusion rates, plasma concentrations, and cardiovascular and metabolic effects during the infusion of norepinephrine in healthy volunteers</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>1992-09</date><risdate>1992</risdate><volume>20</volume><issue>9</issue><spage>1250</spage><epage>1256</epage><pages>1250-1256</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVETo determine the relationship between iv infusion rate, plasma concentrations, and hemodynamic and metabolic actions of norepinephrine. DESIGNNorepinephrine was administered by using five iv infusion rates (0.01 to 0.2 μg/kg/min) for 30 mins each to eight volunteers, for the purpose of constructing cumulative plasma concentration-response curves. SETTINGLaboratory of the Department of Anesthesiology at a university hospital. MEASUREMENTS AND MAIN RESULTSSystolic and diastolic BP, heart rate, and the plasma concentrations of norepinephrine, glucose, non-esterified fatty acids, and insulin were measured at the end of each infusion rate. During the highest infusion rate, plasma norepinephrine concentrations increased from 199 ± 75 to 7475 ± 1071 pg/mL (1.18 ± 0.44 to 44.18 ± 6.33 nmol/L). Typical hemodynamic responses, such as increases in BP and decreases in heart rate, were seen, while the plasma concentrations of glucose and nonesterified fatty acids increased from 92 ± 10 to 132 ± 17 mg/dL (5.1 ± 0.6 to 7.3 ± 0.9 mmol/L) and 11 ± 4 to 34 ± 6 mg/dL (0.11 ± 0.04 to 0.34 ± 0.06 g/L), respectively, during the 0.2 μg/kg/min infusion rate (p &lt;.05). Despite the increase in glucose concentration, insulin remained at baseline values. Metabolic and hemodynamic effects occurred at similar plasma concentrations throughout the study. CONCLUSIONSAdministration of norepinephrine showed no selective hemodynamic actions. The metabolic responses observed in this investigation were similar to those responses seen during increased endogenous sympathetic nervous system activity, such as stress, exercise, or trauma.</abstract><cop>Hagerstown, MD</cop><pub>Williams &amp; Wilkins</pub><pmid>1521439</pmid><doi>10.1097/00003246-199209000-00011</doi><tpages>7</tpages></addata></record>
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source MEDLINE; Journals@Ovid Complete
subjects Adult
Analysis of Variance
Biological and medical sciences
Blood - drug effects
Blood - metabolism
Cardiotonic agents
Cardiovascular system
Cardiovascular System - drug effects
Chromatography, High Pressure Liquid
Dose-Response Relationship, Drug
Hemodynamics - drug effects
Humans
Infusions, Intravenous - methods
Male
Medical sciences
Norepinephrine - administration & dosage
Norepinephrine - blood
Norepinephrine - pharmacology
Pharmacology. Drug treatments
Reference Values
Regression Analysis
Time Factors
title Relationship between infusion rates, plasma concentrations, and cardiovascular and metabolic effects during the infusion of norepinephrine in healthy volunteers
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