Influence of acute epinephrine infusion on endotoxin-induced parameters of heart rate variability: a randomized controlled trial.

Abstract:

OBJECTIVE:To determine whether the acute anti-inflammatory influence of epinephrine (EPI) extends to changes in heart rate variability (HRV) induced by the prototypical inflammatory stimulus, endotoxin (lipopolysaccharide [LPS]). SUMMARY BACKGROUND DATA:HRV reflects fluctuating cardiac autonomic inputs and is acutely reduced during the systemic inflammation induced by LPS as well as during severe critical illnesses such as sepsis and traumatic injury. While EPI may diminish proinflammatory cytokine release, it is unknown whether this net anti-inflammatory activity extends to HRV. METHODS:Healthy volunteers (n = 17) were randomized to either saline + LPS (2 ng/kg) or LPS + antecedent EPI infusion (30 ng/kg/min) from -3 to 6 hours relative to LPS. HRV and blood samples were obtained before EPI and LPS as well as hourly afterward. Plasma cytokines were measured by ELISA. Statistical analysis was by repeated measures analysis of variance. This study was registered at Clinicaltrials.gov and is listed under the following ID number: NCT00753402. RESULTS:LPS acutely influenced all measured parameters of HRV including standard deviation of the average beat to beat intervals over a 5-minute period, percentage of interval differences of successive interbeat intervals greater than 50 milliseconds and square root of the mean squared differences, high frequency (HF), low frequency, low frequency/HF, and very low frequency (all P < 0.01). EPI infusion reduced the inflammatory cytokine response to LPS as measured by decreased TNFalpha, IL-6, and IL-8 (P < 0.01). Relative to the saline + LPS group, antecedent EPI infusion was associated with further reductions in parameters of HRV measuring vagal/parasympathetic activity including, percentage of interval differences of successive interbeat intervals greater than 50 milliseconds, square root of the mean squared differences, and HF (P < 0.05). CONCLUSION:Prior EPI exposure exerts anti-inflammatory influences but also may reduce vagus nerve activity. Hence, acute EPI administration may be protective against early inflammatory challenges but diminish vagal nerve responsiveness to subsequent stimuli.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Jan BU,Coyle SM,Oikawa LO,Lu SE,Calvano SE,Lehrer PM,Lowry SF

doi

10.1097/SLA.0b013e3181a40193

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

750-6

issue

5

eissn

0003-4932

issn

1528-1140

journal_volume

249

pub_type

杂志文章,随机对照试验
  • Perioperative Morbidity and Mortality of Patients With COVID-19 Who Undergo Urgent and Emergent Surgical Procedures.

    abstract:OBJECTIVE:To evaluate the perioperative morbidity and mortality of patients with COVID-19 who undergo urgent and emergent surgery. SUMMARY BACKGROUND DATA:Although COVID-19 infection is usually associated with mild disease, it can lead to severe respiratory complications. Little is known about the perioperative outcom...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000004420

    authors: Knisely A,Zhou ZN,Wu J,Huang Y,Holcomb K,Melamed A,Advincula AP,Lalwani A,Khoury-Collado F,Tergas AI,St Clair CM,Hou JY,Hershman DL,D'Alton ME,Huang YY,Wright JD

    更新日期:2021-01-01 00:00:00

  • Improving the AJCC/TNM staging for adenocarcinomas of the appendix: the prognostic impact of histological grade.

    abstract:PURPOSE:Though histological grade is known to have a major prognostic impact in metastatic mucinous appendiceal adenocarcinomas, the prognostic impact of grade in localized disease, and the validity of the American Joint Committee on Cancer AJCC Staging Manual 7th edition's decision to combine moderately and poorly dif...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318269d680

    authors: Overman MJ,Fournier K,Hu CY,Eng C,Taggart M,Royal R,Mansfield P,Chang GJ

    更新日期:2013-06-01 00:00:00

  • Prospective randomized trial of two wound management strategies for dirty abdominal wounds.

    abstract:OBJECTIVE:To determine the optimal method of wound closure for dirty abdominal wounds. SUMMARY BACKGROUND DATA:The rate of wound infection for dirty abdominal wounds is approximately 40%, but the optimal method of wound closure remains controversial. Three randomized studies comparing delayed primary closure (DPC) wit...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-200103000-00016

    authors: Cohn SM,Giannotti G,Ong AW,Varela JE,Shatz DV,McKenney MG,Sleeman D,Ginzburg E,Augenstein JS,Byers PM,Sands LR,Hellinger MD,Namias N

    更新日期:2001-03-01 00:00:00

  • Colon surgery for cancer in the very elderly. Cost and 3-year survival.

    abstract::Is colon cancer surgery justified in the very elderly from the standpoint of cost and 3-year survival rates? Two hundred eighty patients undergoing major surgery for colon cancer during 1981-1983 were divided into a group of 61 with ages greater than or equal to 80 (GE80) and 219 less than 80 (LT80). Although those GE...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198602000-00003

    authors: Hobler KE

    更新日期:1986-02-01 00:00:00

  • Prevalence and Risk Factors for Bariatric Surgery Readmissions: Findings From 130,007 Admissions in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

    abstract:OBJECTIVE:To evaluate readmissions following laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass (LRYGB). BACKGROUND:Few studies have evaluated national readmission rates for primary bariatric surgery with national, bariatric-specific data. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002079

    authors: Berger ER,Huffman KM,Fraker T,Petrick AT,Brethauer SA,Hall BL,Ko CY,Morton JM

    更新日期:2018-01-01 00:00:00

  • Cholangitis with acute renal failure: priorities in therapeutics.

    abstract::Obstructive cholangitis with acute renal failure is a dramatic syndrome which merits individual definition. Twenty-one patients with acute suppurative cholangitis complicated by rapidly developing renal insufficiency were studied, and the severity of the renal failure, an acute interstitial tubulopathy, bore no signif...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197506000-00022

    authors: Bismuth H,Kuntziger H,Corlette MB

    更新日期:1975-06-01 00:00:00

  • Ultrasonic versus standard electric dissection in laparoscopic colorectal surgery: a prospective randomized clinical trial.

    abstract:OBJECTIVE:To assess the safety and efficacy of the ultrasonic dissection (UC) compared with standard electrosurgery (ES) in laparoscopic colorectal surgery. BACKGROUND DATA:High-frequency ultrasound energy was introduced in laparoscopic surgery to improve dissection and coagulation. Very limited data have been publish...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/01.sla.0000189607.38763.c5

    authors: Morino M,Rimonda R,Allaix ME,Giraudo G,Garrone C

    更新日期:2005-12-01 00:00:00

  • Long term transhepatic intubation for hilar hepatic duct strictures.

    abstract::A technique for repairing benign hilar hepatic duct strictures using transhepatic intubation with a large bore silastic stent is described. This procedure has been used in 10 patients. In 9 instances the stricture involved the common hepatic duct, and in one patient the right and left hepatic ducts. Nine of the strict...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197605000-00005

    authors: Cameron JL,Skinner DB,Zuidema GD

    更新日期:1976-05-01 00:00:00

  • The operative treatment of Crohn's enteritis complicated by ileosigmoid fistula.

    abstract::An ileosigmoid fistula complicating Crohn's disease of the small bowel has been considered a perplexing entity, but in practice does not pose a serious operative problem. The presence of such a fistula does not signify that the sigmoid colon is a primary site of Crohn's disease. The operative treatment of this entity ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198209000-00015

    authors: Block GE,Schraut WH

    更新日期:1982-09-01 00:00:00

  • A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria.

    abstract:OBJECTIVE:To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e3181efc656

    authors: Huang J,Yan L,Cheng Z,Wu H,Du L,Wang J,Xu Y,Zeng Y

    更新日期:2010-12-01 00:00:00

  • Subclassification of Microscopic Vascular Invasion in Hepatocellular Carcinoma.

    abstract:OBJECTIVE:To investigate whether subclassification of microscopic vascular invasion (MiVI) affects the long-term outcome after curative surgical resection or liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). SUMMARY OF BACKGROUND DATA:The most important factor for TNM staging in HCC is MiVI, ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003781

    authors: Kang I,Jang M,Lee JG,Han DH,Joo DJ,Kim KS,Kim MS,Choi JS,Kim SI,Park YN,Choi GH

    更新日期:2020-01-14 00:00:00

  • Management of external gastrointestinal fistulas.

    abstract::We analyzed the course of 186 patients with external gastrointestinal fistulas treated at the University of California Medical Center, San Francisco from 1968 to 1977. There were 82 patients in the earlier group (1968-1971) and 104 patients in the later group (1972-1977). The groups differed in that 35% of patients in...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197810000-00003

    authors: Reber HA,Roberts C,Way LW,Dunphy JE

    更新日期:1978-10-01 00:00:00

  • A systematic proactive risk assessment of hazards in surgical wards: a quantitative study.

    abstract:OBJECTIVE:To identify and prioritize hazards in surgical wards and recommend interventions. BACKGROUND:Retrospective and prospective studies report the frequency and severity of surgical adverse events, but not in sufficient detail to allow interventions to be recommended in surgical wards. METHODS:Seventy hours of o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31824f5f36

    authors: Anderson O,Brodie A,Vincent CA,Hanna GB

    更新日期:2012-06-01 00:00:00

  • Ileal pouch-anal anastomosis: comparison of results in familial adenomatous polyposis and chronic ulcerative colitis.

    abstract::The aim of this study was to compare the immediate postoperative results and the long-term outcome of ileal pouch-anal anastomosis in 94 patients with familial adenomatous polyposis to those in 758 patients with ulcerative colitis. Two colitis patients died after operation (0.3%), but no polyposis patients died. Overa...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198909000-00002

    authors: Dozois RR,Kelly KA,Welling DR,Gordon H,Beart RW Jr,Wolff BG,Pemberton JH,Ilstrup DM

    更新日期:1989-09-01 00:00:00

  • Statins for surgical patients.

    abstract:OBJECTIVE:To evaluate perioperative statin treatment, to explore the rapidly increasing body of literature on the pleiotropic effects of statins, and to suggest a rational strategy of perioperative risk reduction. SUMMARY OF BACKGROUND DATA:Vascular, cerebrovascular, and cardiovascular complications are all too common...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/SLA.0b013e3181492c0d

    authors: Williams TM,Harken AH

    更新日期:2008-01-01 00:00:00

  • A statewide, population-based time-series analysis of the outcome of ruptured abdominal aortic aneurysm.

    abstract:OBJECTIVES:The purpose of this study was to perform the first statewide, population-based, time-series analysis of the frequency of ruptured abdominal aortic aneurysm (RAAA), to determine the outcomes of RAAA, and to assess the association of patient, physician, and hospital factors with survival after RAAA. The hypoth...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199605000-00005

    authors: Rutledge R,Oller DW,Meyer AA,Johnson GJ Jr

    更新日期:1996-05-01 00:00:00

  • Failure-to-pursue rescue: explaining excess mortality in elderly emergency general surgical patients with preexisting "do-not-resuscitate" orders.

    abstract:OBJECTIVE:To describe the outcomes of elderly patients with do-not-resuscitate (DNR) status who undergo emergency general surgery and to improve understanding of the relationship between preoperative DNR status and postoperative mortality. BACKGROUND:Preoperative DNR status has previously been shown to predict increas...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31826578fb

    authors: Scarborough JE,Pappas TN,Bennett KM,Lagoo-Deenadayalan S

    更新日期:2012-09-01 00:00:00

  • Rational use of elemental and nonelemental diets in hospitalized patients.

    abstract::Study A included 30 patients who received immediate postoperative enteral feeding with a nonelemental diet. The nonelemental diet was well tolerated. Study patients rapidly achieved nitrogen equilibrium and had a cumulative nitrogen balance of -11.1 g verus -46.7 g for the control group. In part B, 16 patients with va...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198011000-00003

    authors: Fairfull-Smith R,Abunassar R,Freeman JB,Maroun JA

    更新日期:1980-11-01 00:00:00

  • Prognosis in acute organ-system failure.

    abstract::This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198512000-00004

    authors: Knaus WA,Draper EA,Wagner DP,Zimmerman JE

    更新日期:1985-12-01 00:00:00

  • Artificial anal sphincter in severe fecal incontinence: outcome of prospective experience with 37 patients in one institution.

    abstract:OBJECTIVE:To evaluate the outcome of artificial anal sphincter implantation for severe fecal incontinence in 37 consecutive patients operated on in a single institution from 1993 through 2001. SUMMARY BACKGROUND DATA:Implantation of an artificial anal sphincter is proposed in severe fecal incontinence when local treat...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200301000-00008

    authors: Michot F,Costaglioli B,Leroi AM,Denis P

    更新日期:2003-01-01 00:00:00

  • Neurokinin-2 receptor levels correlate with intensity, frequency, and duration of pain in chronic pancreatitis.

    abstract:OBJECTIVE:Generation and maintenance of pain in chronic pancreatitis (CP) have been shown to be partially attributable to neuroimmune interactions, which involve neuropeptides such as substance P (SP). So far, expression of SP receptors NK-2R, NK-3R, the SP-encoding gene preprotachykinin A (PPT-A), and the SP degradati...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318070d56e

    authors: Michalski CW,Shi X,Reiser C,Fachinger P,Zimmermann A,Büchler MW,Di Sebastiano P,Friess H

    更新日期:2007-11-01 00:00:00

  • Management of spontaneous umbilical hernia disruption in the cirrhotic patient.

    abstract::Umbilical hernia is a common finding in cirrhotic patients with ascites. Spontaneous disruption of the hernia and attendant discharge of ascitic fluid is an unusual and rarely reported complication in these patients and is associated with an overall mortality rate of nearly 30%. During the 5-year period 1977-1982, nin...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198307000-00006

    authors: Lemmer JH,Strodel WE,Knol JA,Eckhauser FE

    更新日期:1983-07-01 00:00:00

  • Clinical effect of allopurinol on preserved kidneys: a randomized double-blind study.

    abstract::We investigated the clinical posttransplant effect of allopurinol on preserved kidneys. Thirty-four paired kidneys from brain-dead cadavers were preserved by hypothermic pulsatile perfusion with silica gel fraction in separate cassettes. Allopurinol was added to one perfusate and omitted from the other in a randomized...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-197701000-00021

    authors: Toledo-Pereyra LH,Simmons RL,Olson LC,Najarian JS

    更新日期:1977-01-01 00:00:00

  • A Clinical Feasibility Trial for Identification of Exceptional Responders in Whom Breast Cancer Surgery Can Be Eliminated Following Neoadjuvant Systemic Therapy.

    abstract:OBJECTIVE:To determine the accuracy of fine-needle aspiration (FNA) and vacuum-assisted core biopsy (VACB) in assessing the presence of residual cancer in the breast after neoadjuvant systemic therapy (NST). SUMMARY BACKGROUND DATA:Pathologic complete response (pCR) rates after NST have improved dramatically, suggesti...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/SLA.0000000000002313

    authors: Kuerer HM,Rauch GM,Krishnamurthy S,Adrada BE,Caudle AS,DeSnyder SM,Black DM,Santiago L,Hobbs BP,Lucci A Jr,Gilcrease M,Hwang RF,Candelaria RP,Chavez-MacGregor M,Smith BD,Arribas E,Moseley T,Teshome M,Miggins MV,Vale

    更新日期:2018-05-01 00:00:00

  • Acute bleeding varices: a five-year prospective evaluation of tamponade and sclerotherapy.

    abstract::In a five-year study of massive upper gastrointestinal hemorrhage, 143 patients had esophageal varices diagnosed on emergency endoscopic examination. Seventy-one patients had active bleeding from varices and required Sengstaken tube tamponade during at least one hospital admission. The remaining patients included 33 w...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198110000-00015

    authors: Terblanche J,Yakoob HI,Bornman PC,Stiegmann GV,Bane R,Jonker M,Wright J,Kirsch R

    更新日期:1981-10-01 00:00:00

  • Hypertonic saline resuscitation of hemorrhagic shock diminishes neutrophil rolling and adherence to endothelium and reduces in vivo vascular leakage.

    abstract:OBJECTIVE:To evaluate the in vivo effects of hypertonic saline (HTS) resuscitation on the interactions of endothelial cells (ECs) and polymorphonuclear neutrophils (PMNs) and vascular permeability after hemorrhagic shock. SUMMARY BACKGROUND DATA:The PMN has been implicated in the pathogenesis of EC damage and organ in...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200211000-00014

    authors: Pascual JL,Ferri LE,Seely AJ,Campisi G,Chaudhury P,Giannias B,Evans DC,Razek T,Michel RP,Christou NV

    更新日期:2002-11-01 00:00:00

  • Vein replacement with fresh vital veins: a comparison of transplantation in RT-1-different rat strain combinations.

    abstract::Transplantation of the intrathoracic inferior vena cava into the abdominal inferior vena cava of the recipient was performed in inbred rat strains of the following combinations: Syngeneic F344 leads to F344, RT-1-identical allogeneic LEW leads to F344, and RT-1-different allogeneic CAP leads to F344. In the RT-1-diffe...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198103000-00006

    authors: Thiede A,Engemann R,Korner HH,Deltz E,Muller-Ruchholtz W

    更新日期:1981-03-01 00:00:00

  • The advantages of 131I-orthoiodohippurate scintiphotography in the management of patients after renal transplantation.

    abstract::Renal scintiphotography with (131)I-hippurate was the primary diagnostic procedure in evaluating renal failure and complications in over 500 transplant patients. This diagnostic test has become our principal method of evaluation and followup of renal transplants, especially in the early post-transplant period. It has ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197409000-00014

    authors: Salvatierra O Jr,Powell MR,Price DC,Kountz SL,Belzer FO

    更新日期:1974-09-01 00:00:00

  • Studies of the modified venous allograft.

    abstract::Segments of rat inferior vena cava were modified by proteolytic digestion and dialdehyde starch tanning in an attempt to alter their antigenic nature and increase their tensile strength. These tissues were found to retain their ability to sensitize allogeneic recipients in both the intradermal and intra-aortic positio...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197708000-00018

    authors: Perloff LJ,Rowlands DT,Barker CF

    更新日期:1977-08-01 00:00:00

  • Reframing Surgical Care: Understanding Complexity and Promoting Teaming.

    abstract::Reframing healthcare delivery in terms of the principles of complex adaptive systems has practical implications for addressing the challenges in improving surgical care. In an Integrated Practice Unit (IPU) - such as a surgical service line, a surgical in-patient floor, or an acute care unit - a diverse group of careg...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001251

    authors: Dillon PW

    更新日期:2015-12-01 00:00:00