Temporary elimination of orthostatic hypotension by norepinephrine infusion

A cardinal manifestation of chronic autonomic failure is neurogenic orthostatic hypotension (OH), which often is associated with supine hypertension, posing a therapeutic dilemma. We report here success in a first step toward development of a “prosthetic baroreceptor system” to maintain blood pressu...

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Bibliographic Details
Published in:Clinical autonomic research 2012-12, Vol.22 (6), p.303-306
Main Authors: Goldstein, David S., Sewell, LaToya, Holmes, Courtney, Pechnik, Sandra, Diedrich, André, Robertson, David
Format: Article
Language:English
Subjects:
Blood Pressure - drug effects
Cardiology
Diabetes
Endocrinology
Gastroenterology
Humans
Hypotension, Orthostatic - drug therapy
Hypotension, Orthostatic - etiology
Infusions, Intra-Arterial
Medicine
Medicine & Public Health
Neurology
Norepinephrine - therapeutic use
Ophthalmology
Parkinson Disease - complications
Parkinson Disease - drug therapy
Pure Autonomic Failure - complications
Pure Autonomic Failure - drug therapy
Short Communication
Tilt-Table Test
Treatment Outcome
Vasoconstrictor Agents - therapeutic use
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Summary:A cardinal manifestation of chronic autonomic failure is neurogenic orthostatic hypotension (OH), which often is associated with supine hypertension, posing a therapeutic dilemma. We report here success in a first step toward development of a “prosthetic baroreceptor system” to maintain blood pressure during orthostasis without worsening supine hypertension. In all of four patients with neurogenic OH, titrated i.v. NE infusion kept directly recorded intra-arterial pressure at or above baseline during progressive head-up tilt. We conclude that titrated i.v. NE infusion temporarily eliminates OH.
ISSN:0959-9851
1619-1560
DOI:10.1007/s10286-012-0176-4