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The effects of intravenous phenylephrine (PE) on aortic blood pressure (AOP), pulmonary artery pressure (PAP), and cardiac output (CO) were evaluated in piglets with normal PAP and piglets with sepsis-induced pulmonary hypertension. Anesthetized, ventilated piglets (1-4 weeks; n = 22) were divided into four groups - group 1 (n = 5) received group B beta streptococci (GBS) followed by PE (300 micrograms/kg); group 2 (n = 6) received GBS alone; group 3 (n = 6) received placebo infusion; group 4 (n = 5) received PE alone (300 micrograms/kg). Infusion of GBS in piglets (groups 1 and 2) elevated PAP by 149 and 176%, reduced CO by 34 and 28%, and did not affect AOP. Administration of PE (groups 1 and 4) raised AOP by 30 and 27% without significantly affecting PAP. However, CO fell after PE by 31 and 39%, respectively. If selective elevation of systemic blood pressure is to become an effective strategy for human newborns with right-to-left shunts caused by sepsis-induced pulmonary hypertension, agents other than PE, with less associated reduction of CO, need to be identified.
W L Meadow, and
B F Rudinsky, and
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April 2003,
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