The Impact of Aramine and Norepinephrine on Hemodynamics and Oxygen Metabolism in Septic Shock Pigs

Objective To investigate the impact of Aramine and Norepinephrine on hemodynamics and oxygen metabolism in septic shock pigs. Methods Ten adult miniature pigs, septic shock models established by intravenous pumping of Escherichia coli lipopolysaccharides, were randomized to the group of Aramine or the group of Norepinephrine. Septic shock pigs were treated according to sepsis shock bundle strategy 1 hour after stable model establishment. Aramine was added to the basic treatment to increase blood pressure in the group of Aramine and, similarly, Norepinephrine was added to increase blood pressure in the group of Norepinephrine. The pulse-indicated continuous cardiac output （PiCCO） monitor was used to record heart rate （HR）, mean arterial pressure （MAP）, cardiac index （CI）, systemic vascular resistance index （SVRI） and arterial blood gas analysis was used to test oxygen saturation （SaO₂）, oxygen saturation of mixed venous blood （SvO₂） and lactate levels as well as calculating oxygen delivery index （DO₂I）, oxygen consumption index （VO₂I）, oxygen extraction rate （O₂ext） and the lactate clearance rate before treatment （T0） and 1/2 hour, 1 hour, 2 hours and 3 hours after treatment （T1/2, T1, T2 and T3）. Results Septic shock pig models were successfully established by continuously intravenous pumping of Escherichia coli lipopolysaccharides and the hemodynamic parameters were significantly improved in both groups after using vasoactive agents （P=0.000）. The HR（t=2.317, t=2.474） and MAP（t=2.284,t=2.313） in T2 and T3 in the group of Norepinephrine were significantly higher than that in the group of Aramine （P<0.05）. The SVRI in T2 in the group of Norepinephrine was significantly higher than that in the group of Aramine （t=2.884,P<0.05）. The CI in T1, T2 and T3 in the group of Norepinephrine was significantly higher than that in the group of Aramine （t=3.360, t=3.058,t=2.559, P<0.05）. The tissue oxygen metabolism parameters of DO₂I, VO₂I, O₂ext and SvO₂ were significantly improved （P<0.05） and serum lactate levels were significantly declined （P=0.000） in two groups. The DO₂I（t=2.832, t=2.680）, VO₂I （t=2.519, t=2.713）and SvO₂（t=2.167, t=2.560） in T2 and T3 in the group of Norepinephrine was significantly higher than that in the group of Aramine （P<0.05）. The serum lactate levels in T1, T2 and T3 in the group of Norepinephrine were significantly lower （t=2.807, t=3.285, t=2.938, P<0.05） and the lactate clearance rate was significantly higher than that in the group of Aramine （t=4.939,P=0.000）. Conclusions Both Aramine and Norepinephrine can effectively improve hemodynamics and oxygen metabolism in septic shock pigs and Norepinephrine takes effect more quickly and effectively than Aramine.