Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men

Henrik Sørensen; J. H. Thomsen; A. S. Ps Meyer; Dijana Terzic; L. Hilsted; J. Kjærgaard; J. P. Goetze; Thales C Barbosa; N. H. Secher

doi:10.1007/s10877-016-9965-y

Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men

Henrik Sørensen^*, J. H. Thomsen, A. S. Ps Meyer, Dijana Terzic, L. Hilsted, J. Kjærgaard, J. P. Goetze, Thales C Barbosa, N. H. Secher

^*Corresponding author af dette arbejde

7 Citationer (Scopus)

Abstract

Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (S_mO₂) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined ± phenylephrine in males during supine rest (n = 17) and 40° HUT (n = 7). MAP, stroke volume (SV), heart rate (HR), and TPR were derived by Modelflow^® and NIRS determined biceps S_mO₂ and (tibial) bone oxygenation (S_tibialO₂). For ten subjects, cardiac filling and the diameter of the inferior caval vein (ICV collapsibility index: ((ICV_expiration − ICV_inspiration)/ICV_expiration) × 100) were assessed by ultrasound. Pancreatic polypeptide (PP) and atrial natriuretic peptide (proANP) in plasma were determined by immunoassay. Brachial artery blood flow was assessed by ultrasound and skin oxygenation (S_skinO₂) monitored by white light spectroscopy. Phenylephrine increased MAP by 34% and TPR (62%; P < 0.001) during supine rest. The ICV collapsibility index decreased (24%; P < 0.001) indicating augmented cardiac preload although volume of the left atrium and ventricle did not change. SV increased (18%; P < 0.001) as HR decreased (24%; P < 0.001). ProANP increased by 9% (P = 0.002) with unaffected PP. Brachial artery blood flow tended to decrease while S_skinO₂ together with S_tibialO₂ decreased by 11% (P = 0.026) and 20% (P < 0.001), respectively. Conversely, phenylephrine increased S_mO₂ (9%) and restored the HUT elicited decrease in S_mO₂ (by 19%) along with SV (P = 0.02). Phenylephrine reduces skin and bone oxygenation and tends to reduce arm blood flow, suggesting that the increase in S_mO₂ reflects veno-constriction with consequent centralization of the blood volume.

Originalsprog	Engelsk
Tidsskrift	Journal of Clinical Monitoring and Computing
Vol/bind	31
Udgave nummer	6
Sider (fra-til)	1159–1166
Antal sider	8
ISSN	1387-1307
DOI	https://doi.org/10.1007/s10877-016-9965-y
Status	Udgivet - 1 dec. 2017

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10.1007/s10877-016-9965-y

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title = "Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men",

abstract = "Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (SmO2) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined ± phenylephrine in males during supine rest (n = 17) and 40° HUT (n = 7). MAP, stroke volume (SV), heart rate (HR), and TPR were derived by Modelflow{\textregistered} and NIRS determined biceps SmO2 and (tibial) bone oxygenation (StibialO2). For ten subjects, cardiac filling and the diameter of the inferior caval vein (ICV collapsibility index: ((ICVexpiration − ICVinspiration)/ICVexpiration) × 100) were assessed by ultrasound. Pancreatic polypeptide (PP) and atrial natriuretic peptide (proANP) in plasma were determined by immunoassay. Brachial artery blood flow was assessed by ultrasound and skin oxygenation (SskinO2) monitored by white light spectroscopy. Phenylephrine increased MAP by 34% and TPR (62%; P < 0.001) during supine rest. The ICV collapsibility index decreased (24%; P < 0.001) indicating augmented cardiac preload although volume of the left atrium and ventricle did not change. SV increased (18%; P < 0.001) as HR decreased (24%; P < 0.001). ProANP increased by 9% (P = 0.002) with unaffected PP. Brachial artery blood flow tended to decrease while SskinO2 together with StibialO2 decreased by 11% (P = 0.026) and 20% (P < 0.001), respectively. Conversely, phenylephrine increased SmO2 (9%) and restored the HUT elicited decrease in SmO2 (by 19%) along with SV (P = 0.02). Phenylephrine reduces skin and bone oxygenation and tends to reduce arm blood flow, suggesting that the increase in SmO2 reflects veno-constriction with consequent centralization of the blood volume.",

keywords = "Atrial natriuretic peptide, Muscle oxygenation, Near infrared spectroscopy, Pancreatic polypeptide, Phenylephrine, Skin oxygenation, Tibial bone oxygenation",

author = "Henrik S{\o}rensen and Thomsen, {J. H.} and Meyer, {A. S. Ps} and Dijana Terzic and L. Hilsted and J. Kj{\ae}rgaard and Goetze, {J. P.} and Barbosa, {Thales C} and Secher, {N. H.}",

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doi = "10.1007/s10877-016-9965-y",

language = "English",

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journal = "Journal of Clinical Monitoring and Computing",

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TY - JOUR

T1 - Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men

AU - Sørensen, Henrik

AU - Thomsen, J. H.

AU - Meyer, A. S. Ps

AU - Terzic, Dijana

AU - Hilsted, L.

AU - Kjærgaard, J.

AU - Goetze, J. P.

AU - Barbosa, Thales C

AU - Secher, N. H.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (SmO2) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined ± phenylephrine in males during supine rest (n = 17) and 40° HUT (n = 7). MAP, stroke volume (SV), heart rate (HR), and TPR were derived by Modelflow® and NIRS determined biceps SmO2 and (tibial) bone oxygenation (StibialO2). For ten subjects, cardiac filling and the diameter of the inferior caval vein (ICV collapsibility index: ((ICVexpiration − ICVinspiration)/ICVexpiration) × 100) were assessed by ultrasound. Pancreatic polypeptide (PP) and atrial natriuretic peptide (proANP) in plasma were determined by immunoassay. Brachial artery blood flow was assessed by ultrasound and skin oxygenation (SskinO2) monitored by white light spectroscopy. Phenylephrine increased MAP by 34% and TPR (62%; P < 0.001) during supine rest. The ICV collapsibility index decreased (24%; P < 0.001) indicating augmented cardiac preload although volume of the left atrium and ventricle did not change. SV increased (18%; P < 0.001) as HR decreased (24%; P < 0.001). ProANP increased by 9% (P = 0.002) with unaffected PP. Brachial artery blood flow tended to decrease while SskinO2 together with StibialO2 decreased by 11% (P = 0.026) and 20% (P < 0.001), respectively. Conversely, phenylephrine increased SmO2 (9%) and restored the HUT elicited decrease in SmO2 (by 19%) along with SV (P = 0.02). Phenylephrine reduces skin and bone oxygenation and tends to reduce arm blood flow, suggesting that the increase in SmO2 reflects veno-constriction with consequent centralization of the blood volume.

AB - Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (SmO2) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined ± phenylephrine in males during supine rest (n = 17) and 40° HUT (n = 7). MAP, stroke volume (SV), heart rate (HR), and TPR were derived by Modelflow® and NIRS determined biceps SmO2 and (tibial) bone oxygenation (StibialO2). For ten subjects, cardiac filling and the diameter of the inferior caval vein (ICV collapsibility index: ((ICVexpiration − ICVinspiration)/ICVexpiration) × 100) were assessed by ultrasound. Pancreatic polypeptide (PP) and atrial natriuretic peptide (proANP) in plasma were determined by immunoassay. Brachial artery blood flow was assessed by ultrasound and skin oxygenation (SskinO2) monitored by white light spectroscopy. Phenylephrine increased MAP by 34% and TPR (62%; P < 0.001) during supine rest. The ICV collapsibility index decreased (24%; P < 0.001) indicating augmented cardiac preload although volume of the left atrium and ventricle did not change. SV increased (18%; P < 0.001) as HR decreased (24%; P < 0.001). ProANP increased by 9% (P = 0.002) with unaffected PP. Brachial artery blood flow tended to decrease while SskinO2 together with StibialO2 decreased by 11% (P = 0.026) and 20% (P < 0.001), respectively. Conversely, phenylephrine increased SmO2 (9%) and restored the HUT elicited decrease in SmO2 (by 19%) along with SV (P = 0.02). Phenylephrine reduces skin and bone oxygenation and tends to reduce arm blood flow, suggesting that the increase in SmO2 reflects veno-constriction with consequent centralization of the blood volume.

KW - Atrial natriuretic peptide

KW - Muscle oxygenation

KW - Near infrared spectroscopy

KW - Pancreatic polypeptide

KW - Phenylephrine

KW - Skin oxygenation

KW - Tibial bone oxygenation

U2 - 10.1007/s10877-016-9965-y

DO - 10.1007/s10877-016-9965-y

M3 - Journal article

C2 - 27987104

AN - SCOPUS:85006416085

SN - 1387-1307

VL - 31

SP - 1159

EP - 1166

JO - Journal of Clinical Monitoring and Computing

JF - Journal of Clinical Monitoring and Computing

IS - 6

ER -

Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men

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