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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">In a high percentage of cases&#44; severe sepsis is accompanied by acute respiratory failure&#44; in which weakness of the respiratory muscles plays an important role&#46; Weakened respiratory muscles that are subjected to an increased mechanical load may develop muscle fatigue&#44; with exacerbation of the respiratory failure&#46; Because &#946;<span class="elsevierStyleInf">2</span>-adrenergic drugs increase muscle contraction force&#44; they may play a role in preventing and managing respiratory failure in septic patients&#46; Our aim was to study the effects of salbutamol on diaphragm function in an animal model of peritoneal sepsis&#46;</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">The study included 3 groups of animals&#58; <span class="elsevierStyleItalic">a&#41;</span> a control group &#40;n&#61;7&#41;&#44; in which the animals underwent a median laparotomy without visceral manipulation&#59; <span class="elsevierStyleItalic">b&#41;</span> a septic group &#40;n&#61;10&#41;&#44; in which peritoneal sepsis was induced by cecal ligation and puncture &#40;CLP&#41;&#59; and <span class="elsevierStyleItalic">c&#41;</span> a salbutamol group &#40;n&#61;7&#41;&#44; in which peritoneal sepsis &#40;CLP&#41; was treated with salbutamol&#46; Hemodynamic parameters and blood gases were measured in vivo&#46; Diaphragm function was evaluated in vitro&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Salbutamol increased aortic blood flow and heart rate while it reduced mean arterial pressure in the animals with peritoneal sepsis &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46; Sepsis produced a significant drop in diaphragmatic force both before and after the application of a muscle-fatigue protocol&#46; Treatment with salbutamol improved muscle contraction force before and after application of the protocol &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The use of &#946;<span class="elsevierStyleInf">2</span>-adrenergic drugs such as salbutamol improves diaphragm function in experimental sepsis&#46; The mechanisms that produce this improvement require further study&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La sepsis grave se acompa&#241;a en un alto porcentaje de casos de insuficiencia respiratoria aguda&#44; donde la debilidad de los m&#250;sculos respiratorios desempe&#241;a un papel importante&#46; Los m&#250;sculos respiratorios debilitados y sometidos a una carga mec&#225;nica aumentada pueden evolucionar a fatiga muscular con agravamiento de la insuficiencia respiratoria&#46; Los f&#225;rmacos adren&#233;rgicos &#946;<span class="elsevierStyleInf">2</span>&#44; al mejorar la fuerza de contracci&#243;n muscular&#44; podr&#237;an ser de utilidad en la prevenci&#243;n y el manejo de la insuficiencia respiratoria de pacientes con sepsis&#46; El objetivo de este trabajo ha sido estudiar los efectos del salbutamol en la funci&#243;n diafragm&#225;tica en un modelo animal de sepsis peritoneal&#46;</p> <span class="elsevierStyleSectionTitle">Material y M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 3 grupos de animales&#58; <span class="elsevierStyleItalic">a&#41;</span> grupo control &#40;n &#61; 7&#41;&#44; al que se realiz&#243; laparotom&#237;a mediana sin abordaje visceral&#59;<span class="elsevierStyleItalic">b&#41;</span> grupo sepsis &#40;n &#61; 10&#41;&#44; al que se indujo sepsis peritoneal por ligadura y punci&#243;n cecal &#40;LPC&#41;&#44; y <span class="elsevierStyleItalic">c&#41;</span> grupo salbutamol &#40;n &#61; 7&#41;&#44; en el que la sepsis peritoneal se trat&#243; con salbutamol &#40;LPC &#43; salbutamol&#41;&#46; Los par&#225;metros hemodin&#225;micos y los gases sangu&#237;neos se midieron in vivo&#46; La funci&#243;n diafragm&#225;tica se evalu&#243; in vitro&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El salbutamol aument&#243; el flujo a&#243;rtico y la frecuencia card&#237;aca a la vez que disminuy&#243; la presi&#243;n arterial media en la sepsis peritoneal &#40;p &#60; 0&#44;05&#41;&#46; La sepsis determin&#243; una ca&#237;da significativa de la fuerza diafragm&#225;tica tanto antes como despu&#233;s de un protocolo de fatiga muscular&#46; El tratamiento con salbutamol mejor&#243; la fuerza de contracci&#243;n muscular en ambos casos &#40;p &#60; 0&#44;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El uso de agentes adren&#233;rgicos &#946;<span class="elsevierStyleInf">2</span> como el salbutamol mejora la funci&#243;n diafragm&#225;tica durante la sepsis experimental&#46; Los mecanismos de esta mejor&#237;a deben estudiarse en mayor profundidad&#46;</p>"
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Vol. 44. Issue 3.
Pages 135-139 (January 2008)
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Vol. 44. Issue 3.
Pages 135-139 (January 2008)
Original Articles
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Salbutamol Improves Diaphragm Force Generation in Experimental Sepsis
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Héctor Píriz
Corresponding author
hpiriz@hc.edu.uy

Correspondence: Dr H. Píriz. Facultad de Medicina, Hospital de Clínicas Avda. Italia, s/n, piso 15 11600 Montevideo, Uruguay
, Nicolás Nin, José Boggia, Martín Angulo, Francisco Javier Hurtado
Departamento de Fisiopatología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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Article information
Objective

In a high percentage of cases, severe sepsis is accompanied by acute respiratory failure, in which weakness of the respiratory muscles plays an important role. Weakened respiratory muscles that are subjected to an increased mechanical load may develop muscle fatigue, with exacerbation of the respiratory failure. Because β2-adrenergic drugs increase muscle contraction force, they may play a role in preventing and managing respiratory failure in septic patients. Our aim was to study the effects of salbutamol on diaphragm function in an animal model of peritoneal sepsis.

Material and Methods

The study included 3 groups of animals: a) a control group (n=7), in which the animals underwent a median laparotomy without visceral manipulation; b) a septic group (n=10), in which peritoneal sepsis was induced by cecal ligation and puncture (CLP); and c) a salbutamol group (n=7), in which peritoneal sepsis (CLP) was treated with salbutamol. Hemodynamic parameters and blood gases were measured in vivo. Diaphragm function was evaluated in vitro.

Results

Salbutamol increased aortic blood flow and heart rate while it reduced mean arterial pressure in the animals with peritoneal sepsis (P<.05). Sepsis produced a significant drop in diaphragmatic force both before and after the application of a muscle-fatigue protocol. Treatment with salbutamol improved muscle contraction force before and after application of the protocol (P<.05).

Conclusions

The use of β2-adrenergic drugs such as salbutamol improves diaphragm function in experimental sepsis. The mechanisms that produce this improvement require further study.

Key words:
Respiratory muscles
Sepsis
Diaphragmatic dysfunction
β2-adrenergic drugs
Objetivo

La sepsis grave se acompaña en un alto porcentaje de casos de insuficiencia respiratoria aguda, donde la debilidad de los músculos respiratorios desempeña un papel importante. Los músculos respiratorios debilitados y sometidos a una carga mecánica aumentada pueden evolucionar a fatiga muscular con agravamiento de la insuficiencia respiratoria. Los fármacos adrenérgicos β2, al mejorar la fuerza de contracción muscular, podrían ser de utilidad en la prevención y el manejo de la insuficiencia respiratoria de pacientes con sepsis. El objetivo de este trabajo ha sido estudiar los efectos del salbutamol en la función diafragmática en un modelo animal de sepsis peritoneal.

Material y Métodos

Se estudiaron 3 grupos de animales: a) grupo control (n = 7), al que se realizó laparotomía mediana sin abordaje visceral;b) grupo sepsis (n = 10), al que se indujo sepsis peritoneal por ligadura y punción cecal (LPC), y c) grupo salbutamol (n = 7), en el que la sepsis peritoneal se trató con salbutamol (LPC + salbutamol). Los parámetros hemodinámicos y los gases sanguíneos se midieron in vivo. La función diafragmática se evaluó in vitro.

Resultados

El salbutamol aumentó el flujo aórtico y la frecuencia cardíaca a la vez que disminuyó la presión arterial media en la sepsis peritoneal (p < 0,05). La sepsis determinó una caída significativa de la fuerza diafragmática tanto antes como después de un protocolo de fatiga muscular. El tratamiento con salbutamol mejoró la fuerza de contracción muscular en ambos casos (p < 0,05).

Conclusiones

El uso de agentes adrenérgicos β2 como el salbutamol mejora la función diafragmática durante la sepsis experimental. Los mecanismos de esta mejoría deben estudiarse en mayor profundidad.

Palabras clave:
Músculos respiratorios
Sepsis
Disfunción diafragmática
Adrenérgicos β2
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