Microcirculatory effects of enalaprilat in an ovine model of severe sepsis

AbstractINTRODUCTION. Patients with severe sepsis present high levels of angiotensin II (ang II), a hormone with vasoactive, proinflammatory, and procoagulant properties. Despite seemingly adequate hemodynamic resuscitation, microcirculatory abnormalities are frequently observed. Increased serum levels of ang II may play a role in this microcirculatory dysfunction during severe sepsis.OBJECTIVES. To evaluate the microcirculatory effects of enalaprilat in an experimental model of severe sepsis.METHODS. Prospective, randomized, double-blind, placebo controlled study including 16 adult female anesthetized, mechanically ventilated sheep. One hour after injection of 1.5 g/kg body weight of feces into the abdominal cavity, animals were randomized to receive either enalaprilat 2.5 mg or saline. A combination of Ringer's lactate (RL) and hydroxyethyl starch solutions was titrated to prevent hypovolemia. When fluid-resistant hypotension (MAP