{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:00:27Z","timestamp":1790834427819,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2010,5,6]],"date-time":"2010-05-06T00:00:00Z","timestamp":1273104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2010,8]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold>Recent experimental studies have shown that a norepinephrine\u2010induced increase in blood pressure induces a loss of plasma volume, particularly under increased microvascular permeability. We studied the effects of norepinephrine\u2010induced variations in the mean arterial pressure (MAP) on plasma volume changes and systemic haemodynamics in patients with vasodilatory shock.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold>Twenty\u2010one mechanically ventilated patients who required norepinephrine to maintain MAP \u226570\u2003mmHg because of septic\/postcardiotomy vasodilatory shock were included. The norepinephrine dose was randomly titrated to target MAPs of 60, 75 and 90\u2003mmHg. At each target MAP, data on systemic haemodynamics, haematocrit, arterial and mixed venous oxygen content and urine flow urine were measured. Changes in the plasma volume were calculated as 100 \u00d7 (Hct<jats:sub>pre<\/jats:sub>\/Hct<jats:sub>post<\/jats:sub>\u22121)\/ (1\u2212Hct<jats:sub>pre<\/jats:sub>), where Hct<jats:sub>pre<\/jats:sub>and Hct<jats:sub>post<\/jats:sub>are haematocrits before and after intervention.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold>Norepinephrine doses to obtain target MAPs of 60, 75 and 90\u2003mmHg were 0.20\u00b10.18, 0.29\u00b10.18 and 0.42\u00b10.31\u2003\u03bcg\/kg\/min, respectively. From 60 to 90\u2003mmHg, increases in the cardiac index (15%), systemic oxygen delivery index (25%), central venous pressure (CVP) (20%) and pulmonary artery occlusion pressure (33%) were seen, while the intrapulmonary shunt fraction was unaffected by norepinehrine. Plasma volume decreased by 6.5% and 9.4% (<jats:italic>P<\/jats:italic>&lt;0.0001) when blood pressure was increased from 60 to 75 and 90\u2003mmHg, respectively. MAP (<jats:italic>P<\/jats:italic>&lt;0.02) independently predicted the decrease in plasma volume with norepinephrine but not CVP (<jats:italic>P<\/jats:italic>=0.19), cardiac index (<jats:italic>P<\/jats:italic>=0.73), norepinephrine dose (<jats:italic>P<\/jats:italic>=0.58) or urine flow (<jats:italic>P<\/jats:italic>=0.64).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold>Norepinephrine causes a pressure\u2010dependent decrease in the plasma volume in patients with vasodilatory shock most likely caused by transcapillary fluid extravasation.<\/jats:p>","DOI":"10.1111\/j.1399-6576.2010.02244.x","type":"journal-article","created":{"date-parts":[[2010,5,6]],"date-time":"2010-05-06T20:12:55Z","timestamp":1273176775000},"page":"814-820","source":"Crossref","is-referenced-by-count":36,"title":["Norepinephrine causes a pressure\u2010dependent plasma volume decrease in clinical vasodilatory shock"],"prefix":"10.1111","volume":"54","author":[{"given":"A.","family":"NYGREN","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"REDFORS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"THOR\u00c9N","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010E.","family":"RICKSTEN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,7,5]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra002709"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199305203282008"},{"key":"e_1_2_7_4_2","first-page":"296","article-title":"Surviving Sepsis Campaign","volume":"36","author":"Dellinger RP","year":"2008","journal-title":"international guidelines for management of severe sepsis and septic shock: 2008"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199906000-00033"},{"key":"e_1_2_7_6_2","first-page":"7","article-title":"The effects of vasopressin on systemic hemodynamics in catecholamine\u2010resistant septic and postcardiotomy shock","volume":"93","author":"Dunser MW","year":"2001","journal-title":"a retrospective analysis"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-002-1265-y"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199309000-00012"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2008.01900.x"},{"key":"e_1_2_7_10_2","first-page":"781","article-title":"Increased vascular permeability","volume":"1","author":"Fleck A","year":"1985","journal-title":"a major cause of hypoalbuminemia in disease and injury"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200204000-00008"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000081431.50015.46"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2005.01.029"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0756-2"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mvr.2008.04.006"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.6.1644"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.4.1229"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2007.01351.x"},{"key":"e_1_2_7_19_2","first-page":"446","article-title":"Calculating correlation coefficients with repeated observations","volume":"310","author":"Bland JM","year":"1995","journal-title":"part 1, Correlation within subjects"},{"key":"e_1_2_7_20_2","first-page":"400","article-title":"Mechanisms mediating pressure natriuresis","volume":"32","author":"Evans RG","year":"2005","journal-title":"what we know and what we need to find out"},{"key":"e_1_2_7_21_2","first-page":"348","volume-title":"Textbook of medical physiology","author":"Guyton AC","year":"2006"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1993.tb03728.x"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.25.5.1096"},{"key":"e_1_2_7_24_2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.33549\/physiolres.930041","article-title":"Cardiovascular and hormonal changes with different angles of head\u2010up tilt in men","volume":"50","author":"Laszlo Z","year":"2001","journal-title":"Physiol Res"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00055.2001"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-004-1224-0"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1681.2005.04289.x"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00040.2002"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1993.74.3.1024"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024942132705"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1399-6576.2010.02244.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1399-6576.2010.02244.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T17:27:27Z","timestamp":1740072447000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1399-6576.2010.02244.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,7,5]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2010,8]]}},"alternative-id":["10.1111\/j.1399-6576.2010.02244.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1399-6576.2010.02244.x","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,7,5]]}}}