Nonselective versus selective inhibition of inducible nitric oxide synthase in experimental endotoxic shock.

The effects of two nitric oxide synthase (NOS) inhibitors with different isoform selectivity were compared in a murine model of endotoxemia. Mice challenged with 70 mg/kg intraperitoneal (ip) lipopolysaccharide (LPS) were treated 6 h after LPS with either NG-gamma-L-arginine methyl ester (L-NAME, nonselective NOS inhibitor, 10-60 mg/kg), L-canavanine (selective inhibitor of inducible NOS, 50-300 mg/kg), or saline (0.2 mL) given ip.

L-canavanine improves organ function and tissue adenosine triphosphate levels in rodent endotoxemia.

Overproduction of NO by an inducible NO synthase (iNOS) plays a major role in the pathophysiology of septic shock, and selective inhibition of iNOS in this setting could be of great therapeutic value. In the present study, we evaluated the effects of L-canavanine, a selective iNOS inhibitor, in an animal model of septic shock, with a particular focus on tissue oxidative metabolism and organ functions. Anesthetized rats challenged intravenously with lipopolysacharide (LPS) were treated after 1 h by a continuous infusion of either L-canavanine (20 mg/kg/h; n = 11) or an equivalent volume of saline (2 ml/kg/h; n = 17) given for 4 h.

L-canavanine, an inhibitor of inducible nitric oxide synthase, improves venous return in endotoxemic rats.

Objective: To investigate the hemodynamic effects of L-canavanine (an inhibitor of inducible, but not of constitutive, nitric oxide synthase) in endotoxic shock.

Design: Controlled, randomized, experimental study.

Setting: Animal laboratory.

Cerebral thromboembolism after direct current cardioversion for pure atrial flutter.

The need for prophylactic anticoagulation before electrical cardioversion for atrial arrhythmias is clearly established in the case of atrial fibrillation. By contrast, such prophylaxis is not a current standard of care before cardioversion for pure atrial flutter, since this arrhythmia seems not to increase the risk of postcardioversion embolism. We present a patient who developed two cerebral embolisms 24 h after electrical cardioversion for pure atrial flutter.

Beneficial effects of L-canavanine, a selective inhibitor of inducible nitric oxide synthase, during rodent endotoxaemia.

1. The cardiovascular failure in sepsis may result from increased nitric oxide biosynthesis, through the diffuse expression of an inducible nitric oxide synthase. In such conditions, nitric oxide synthase inhibitors might be of therapeutic value, but detrimental side effects have been reported with their use, possibly related to the blockade of constitutive nitric oxide synthase.

[Myocardial lesion secondary to defibrillation. Literature review and practical implications].

A 39 years old patient was defibrillated during the acute stage of an inferior myocardial infarction. He presented an elevation of the ST segment in the right precordial leads immediately after resuscitation. The evolution of the electrocardiographic changes were characterised by the development of a septo-apical subepicardial necrosis, whose sequelae remained nine months after the initial event.