Effect of estradiol administration on splanchnic perfusion after trauma-hemorrhage and sepsis

Yukihiro Yokoyama, Martin G Schwacha, Kirby I. Bland, Irshad H. Chaudry

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose of review: This review focuses on the latest mechanistic understanding of the effects of estradiol on the splanchnic circulation and the possibility of estradiol treatment as an adjunct for the treatment of trauma-hemorrhage and sepsis. Recent findings: Systemic hypotension induced by shock accompanies marked alterations in blood flow to various organs. Decreased splanchnic perfusion is frequently observed after insults, such as severe hemorrhage or sepsis, which leads to the destruction of the intestinal mucosal barrier and hepatic dysfunction. Studies suggest that estradiol acts as a facilitator of the intestinal blood flow via the increased production of nitric oxide, decreased production of vasoconstrictors, attenuated neutrophil adhesion, and decreased formation of oxygen free radicals. Summary: Trauma-hemorrhage results in decreased circulating blood volume. In contrast, sepsis is an inflammatory state mainly mediated by bacterial products. However, these divergent insults show similar pathophysiologic alterations in terms of the splanchnic circulation. Because estradiol effectively protects the organs from circulatory failure after various adverse circulatory conditions, many studies are being performed to clarify the molecular mechanism of estradiol action with regard to tissue circulation. Estradiol improves the macro- and microcirculation of the splanchnic organs by multiple mechanisms. Nonetheless, it remains unclear which mechanism plays the most important role in the treatment of trauma-hemorrhage and sepsis. Additional studies are required to elucidate the precise mechanism of estradiol action and to determine the usefulness of estradiol treatment for severe hemorrhage and sepsis in patients.

Original languageEnglish (US)
Pages (from-to)137-142
Number of pages6
JournalCurrent Opinion in Critical Care
Volume9
Issue number2
DOIs
StatePublished - Apr 2003
Externally publishedYes

Fingerprint

Viscera
Estradiol
Sepsis
Perfusion
Hemorrhage
Wounds and Injuries
Splanchnic Circulation
Shock
Controlled Hypotension
Vasoconstrictor Agents
Therapeutics
Microcirculation
Blood Volume
Free Radicals
Reactive Oxygen Species
Nitric Oxide
Neutrophils
Liver

Keywords

  • Endothelin
  • Gender
  • Neutrophil
  • Nitric oxide
  • Superoxide

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Effect of estradiol administration on splanchnic perfusion after trauma-hemorrhage and sepsis. / Yokoyama, Yukihiro; Schwacha, Martin G; Bland, Kirby I.; Chaudry, Irshad H.

In: Current Opinion in Critical Care, Vol. 9, No. 2, 04.2003, p. 137-142.

Research output: Contribution to journalArticle

Yokoyama, Yukihiro ; Schwacha, Martin G ; Bland, Kirby I. ; Chaudry, Irshad H. / Effect of estradiol administration on splanchnic perfusion after trauma-hemorrhage and sepsis. In: Current Opinion in Critical Care. 2003 ; Vol. 9, No. 2. pp. 137-142.
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