 |
|
Endorphins in Septic ShockHemodynamic and Endocrine Effects of an Opiate Receptor Antagonist and Agonist
Fivos N. Gahhos, MD;
Ray C. J. Chiu, MD, PhD;
E. John Hinchey, MD;
Geoffrey K. Richards, MD
Arch Surg. 1982;117(8):1053-1057.
Abstract
• The pathophysiological role of endorphins in septic shock was studied in a porcine model. Septic shock was induced by the intravenous infusion of live Escherichia coli. Naloxone hydrochloride, an opiate receptor blocker, given during profound septic shock, increased blood concentrations of glucagon and cyclic adenosine monophosphate (cAMP), while BP and cardiac output increased transiently. Heart rate and hepatic glycogen value decreased, but insulin and cortisol levels remained unchanged. In contrast, exogenous morphine injection produced further reduction of BP, increased pulmonary wedge pressure, and increased substance P, while growth hormone level and cardiac output remained unchanged. Neither hormonal nor hemodynamic changes were noted in saline controls. Thus, the endogenous opiates appear partly responsible for the hemodynamic derangements during septic shock, and naloxone is able to reverse such depression, even though the effects are transient and relatively minor when naloxone is given late in the course of septic shock. Endogenous opiates also affect hormonal homeostasis in shock, and there are indications that this may be mediated by the adenylate cyclase-cAMP system.
(Arch Surg 1982;117:1053-1057)
Author Affiliations
From the Departments of Surgery (Drs Gahhos, Chiu, and Hinchey) and Bacteriology (Dr Richards), the Montreal General Hospital and McGill University.
Footnotes
Accepted for publication Feb 23, 1982.
Read in part before the American College of Surgeons, Atlanta, Oct 20, 1980.
Reprint requests to The Montreal General Hospital, 1650 Cedar Ave, Montreal, Quebec, Canada H3G 1A4 (Dr Chiu).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Prevention of Septic Ventilatory Depression With Naloxone
Chuang et al.
Arch Surg 1987;122:940-945.
ABSTRACT
Multiple-Organ-Failure Syndrome
Carrico et al.
Arch Surg 1986;121:196-208.
ABSTRACT
Evaluation of Naloxone for Therapy of Escherichia coli Shock: Species Differences
Hinshaw et al.
Arch Surg 1984;119:1410-1418.
ABSTRACT
|
