The effect of indomethacin on systemic and renal hemodynamics in neonatal piglets during experimental endotoxemia

Pediatr Surg Int. 2008 Aug;24(8):907-11. doi: 10.1007/s00383-008-2175-z. Epub 2008 May 29.

Abstract

Systemic and renal hemodynamics are affected by prostaglandin production during endotoxemia. To study indomethacin effects on endotoxinemia in a neonatal piglet model, sixteen 7-10 day old piglets were anesthetized, ventilated, and catheterized. Mean arterial pressure (MAP), heart rate (HR), and urine output were continuously monitored. Endotoxin (0.06 mcg/kg) was injected after baseline measurements. We studied two groups with either endotoxinemia alone (n = 7) or an additional indomethacin infusion (0.2 mg/kg per h, n = 9). HR, MAP, renal blood flow (RBF), systemic and renal vascular resistance (SVR, RVR), cardiac index (CI), and glomerular filtration rate (GFR), were obtained at baseline, at 1, 2 and 3 h. We observed a drop in CI and an increase in SVR and HR within 3 h of endotoxinemia, while MAP remained unchanged. These effects were prevented by indomethacin. RVR was not altered significantly. Endotoxinemia triggered a drop of RBF in both control (P < 0.01) and intervention group (P < 0.05). In the intervention group, drop of GFR, urine volume, and paraaminohippuric acid clearance were apparent signs of nephrotoxicity (P < 0.01, <0.05, and <0.01). In conclusion, indomethacin maintains hemodynamic parameters during endotoxinemia at the expense of nephrotoxicity. We speculate that indomethacin counteracts the renoprotective effect of prostaglandins.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Animals, Newborn
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Blood Flow Velocity / drug effects
  • Blood Flow Velocity / physiology
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology
  • Disease Models, Animal
  • Endotoxemia / drug therapy*
  • Endotoxemia / physiopathology
  • Escherichia coli Infections / drug therapy*
  • Escherichia coli Infections / physiopathology
  • Glomerular Filtration Rate / drug effects
  • Glomerular Filtration Rate / physiology
  • Heart Rate / drug effects*
  • Heart Rate / physiology
  • Indomethacin / therapeutic use*
  • Renal Circulation / drug effects*
  • Renal Circulation / physiology
  • Swine
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Indomethacin