Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study
Background Venous waveform analysis is an emerging technique to estimate intravascular fluid status by fast Fourier transform deconvolution. Fluid status has been shown proportional to f0, the amplitude of the fundamental frequency of the waveform’s cardiac wave upon deconvolution. Using a porcine m...
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Taylor & Francis Group
2025-12-01
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| Series: | Journal of Investigative Surgery |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/08941939.2024.2445603 |
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| author | Zachary R. Bergman Roy K. Kiberenge Richard W. Bianco Gregory J. Beilman Colleen M. Brophy Kyle M. Hocking Bret D. Alvis Eric S. Wise |
| author_facet | Zachary R. Bergman Roy K. Kiberenge Richard W. Bianco Gregory J. Beilman Colleen M. Brophy Kyle M. Hocking Bret D. Alvis Eric S. Wise |
| author_sort | Zachary R. Bergman |
| collection | DOAJ |
| description | Background Venous waveform analysis is an emerging technique to estimate intravascular fluid status by fast Fourier transform deconvolution. Fluid status has been shown proportional to f0, the amplitude of the fundamental frequency of the waveform’s cardiac wave upon deconvolution. Using a porcine model of distributive shock and fluid resuscitation, we sought to determine the influence of norepinephrine on f0 of the central venous waveform.Methods Eight pigs were anesthetized, catheterized and treated with norepinephrine after precipitation of endotoxemic hypotension, and subsequent fluid resuscitation to mimic sepsis physiology. Hemodynamic parameters and central venous waveforms were continually transduced throughout the protocol for post-hoc analysis. Central venous waveform f0 before, during and after norepinephrine administration were determined using Fourier analysis.Results Heart rate increased, while central venous pressure, pulmonary capillary wedge pressure and stroke volume decreased throughout norepinephrine administration (p < 0.05). Mean f0 at pre-norepinephrine, and doses 0.05, 0.10, 0.15, 0.20 and 0.25 mcg/kg/min, were 2.5, 1.4, 1.7, 1.7, 1.6 and 1.4 mmHg2, respectively (repeated measures ANOVA; p < 0.001). On post-hoc comparison to pre-norepinephrine, f0 at 0.05 mcg/kg/min was decreased (p = 0.04).Conclusions As the performance of f0 was previously characterized during fluid administration, these data offer novel insight into the performance of f0 during vasopressor delivery. Central venous waveform f0 is a decreased with norepinephrine, in concordance with pulmonary capillary wedge pressure. This allows contextualization of the novel, venous-derived signal f0 during vasopressor administration, a finding that must be understood prior to clinical translation. |
| format | Article |
| id | doaj-art-87d91ba350cc460ab8c47b3f452435bd |
| institution | Kabale University |
| issn | 0894-1939 1521-0553 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj-art-87d91ba350cc460ab8c47b3f452435bd2025-01-07T01:03:01ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532025-12-0138110.1080/08941939.2024.2445603Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal StudyZachary R. Bergman0Roy K. Kiberenge1Richard W. Bianco2Gregory J. Beilman3Colleen M. Brophy4Kyle M. Hocking5Bret D. Alvis6Eric S. Wise7Department of Surgery, University of Minnesota Twin Cities Medical School, Minneapolis, MN, USADepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USADepartment of Surgery, University of Minnesota Twin Cities Medical School, Minneapolis, MN, USADepartment of Surgery, University of Minnesota Twin Cities Medical School, Minneapolis, MN, USADepartment of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USADepartment of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USADepartment of Biomedical Engineering, Vanderbilt University, Nashville, TN, USADepartment of Surgery, University of Minnesota Twin Cities Medical School, Minneapolis, MN, USABackground Venous waveform analysis is an emerging technique to estimate intravascular fluid status by fast Fourier transform deconvolution. Fluid status has been shown proportional to f0, the amplitude of the fundamental frequency of the waveform’s cardiac wave upon deconvolution. Using a porcine model of distributive shock and fluid resuscitation, we sought to determine the influence of norepinephrine on f0 of the central venous waveform.Methods Eight pigs were anesthetized, catheterized and treated with norepinephrine after precipitation of endotoxemic hypotension, and subsequent fluid resuscitation to mimic sepsis physiology. Hemodynamic parameters and central venous waveforms were continually transduced throughout the protocol for post-hoc analysis. Central venous waveform f0 before, during and after norepinephrine administration were determined using Fourier analysis.Results Heart rate increased, while central venous pressure, pulmonary capillary wedge pressure and stroke volume decreased throughout norepinephrine administration (p < 0.05). Mean f0 at pre-norepinephrine, and doses 0.05, 0.10, 0.15, 0.20 and 0.25 mcg/kg/min, were 2.5, 1.4, 1.7, 1.7, 1.6 and 1.4 mmHg2, respectively (repeated measures ANOVA; p < 0.001). On post-hoc comparison to pre-norepinephrine, f0 at 0.05 mcg/kg/min was decreased (p = 0.04).Conclusions As the performance of f0 was previously characterized during fluid administration, these data offer novel insight into the performance of f0 during vasopressor delivery. Central venous waveform f0 is a decreased with norepinephrine, in concordance with pulmonary capillary wedge pressure. This allows contextualization of the novel, venous-derived signal f0 during vasopressor administration, a finding that must be understood prior to clinical translation.https://www.tandfonline.com/doi/10.1080/08941939.2024.2445603Central venous pressurevenous waveform analysisanimal modelsshockvolume status |
| spellingShingle | Zachary R. Bergman Roy K. Kiberenge Richard W. Bianco Gregory J. Beilman Colleen M. Brophy Kyle M. Hocking Bret D. Alvis Eric S. Wise Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study Journal of Investigative Surgery Central venous pressure venous waveform analysis animal models shock volume status |
| title | Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study |
| title_full | Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study |
| title_fullStr | Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study |
| title_full_unstemmed | Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study |
| title_short | Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study |
| title_sort | norepinephrine infusion and the central venous waveform in a porcine model of endotoxemic hypotension with resuscitation a large animal study |
| topic | Central venous pressure venous waveform analysis animal models shock volume status |
| url | https://www.tandfonline.com/doi/10.1080/08941939.2024.2445603 |
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