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Mechanisms of Vascular Impairment During Endotoxaemia with Special Reference to the Role of the L-arginine Pathway

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Shock, Sepsis, and Organ Failure

Abstract

The pattern of vascular tone seen in patients with the sepsis syndrome is generally, and certainly in the early stages, one of reduced peripheral vascular resistance, often with a normal or elevated cardiac output (Siegel et al. 1971; Groeneveld et al. 1986; Thijs and Groeneveld 1988). This loss of vascular tone can be persistent (‘unrelenting hypotension’: Thijs et al. 1987) and is one of the major causes of death in these patients (Parker et al. 1984). Circulating endotoxin (lipopolysaccharide; LPS) is an important component of human shock pathogenesis; indeed, the administration of small doses of endotoxin to human volunteers results in a cardiovascular pattern identical to that seen early in septic shock (Parrillo, 1989).

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Authors and Affiliations

  1. Laboratoire de Pharmacologie Cellulaire et Moleculaire, CNRS URA 6000, Université Louis Pasteur, Strasbourg, France

    I. Fleming, G. A. Gray, G. Julou-Schaeffer, M. Bigaud & J.-C. Stoclet

  2. Department of Physiology and Pharmacology, Royal College, University of Strathclyde, Glasgow, G1 1XW, Scotland, UK

    B. L. Furman, M. O. Guc & J. R. Parratt

Authors
  1. I. Fleming
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  2. B. L. Furman
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  3. G. A. Gray
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  4. M. O. Guc
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  5. G. Julou-Schaeffer
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  6. M. Bigaud
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  7. J.-C. Stoclet
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  8. J. R. Parratt
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Editors and Affiliations

  1. Ludwig-Boltzmann-Institut für experimentelle und klinische Traumatologie, Donaueschingenstraße 13, 1200, Wien, Austria

    Günther Schlag  & Heinz Redl  & 

  2. Maryland Institute for Emergency Medical Services Systems, Department of Surgery, Medical School, University of Maryland, 22 S. Greene Street, Baltimore, MD, 21201, USA

    John H. Siegel MD

  3. School of Medicine, John Hopkins University, 22 S. Greene Street, Baltimore, MD, 21201, USA

    John H. Siegel MD

  4. Shriners Burns Institute and The University of Texas Medical Branch, 610 Texas Avenue, Galveston, Texas, 77550, USA

    Daniel L. Traber

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© 1991 Springer-Verlag Berlin, Heidelberg

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Fleming, I. et al. (1991). Mechanisms of Vascular Impairment During Endotoxaemia with Special Reference to the Role of the L-arginine Pathway. In: Schlag, G., Redl, H., Siegel, J.H., Traber, D.L. (eds) Shock, Sepsis, and Organ Failure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76511-7_16

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  • DOI: https://doi.org/10.1007/978-3-642-76511-7_16

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