TY - JOUR T1 - REcombinant human tumor necrosis factor produces hemodynamic changes characteristic of sepsis and endotoxemia AU - Schirmer WJ, Schirmer JM, Fry DE Y1 - 1989/04/01 N1 - 10.1001/archsurg.1989.01410040055012 JO - Archives of Surgery SP - 445 EP - 448 VL - 124 IS - 4 N2 - • Tumor necrosis factor (TNF) is a macrophage-derived peptide mediator released during endotoxemia and sepsis. We examined the systemic and visceral hemodynamic response to low doses of human recombinant TNF in rats. Each animal received a 30-minute intravenous infusion of either saline solution (n=8) or TNF (n=8) in a dose of 0.25 mg/kg or 1.0 mg/kg. Thermodilution cardiac output, blood pressure, pulse, vascular resistance, effective hepatic blood flow (galactose clearance), and effective renal plasma flow (p-aminohippurate clearance) were determined at time=2 hours. The 0.25-mg/kg dose had no apparent effect on systemic hemodynamics. The 1.0-mg/kg dose produced a hyperdynamic systemic circulatory response with an elevated cardiac output, tachycardia, and a diminished systemic vascular resistance. Effective hepatic blood flow was exquisitely sensitive to even the lowest dose of TNF, with a 29% reduction despite the normal cardiac output. Renal flow was unaffected by either dose. Tumor necrosis factor–induced systemic and visceral hemodynamic changes are remarkably similar to those seen in gram-negative sepsis, suggesting that TNF may occupy a proximal position in the pathogenesis of overwhelming infection.(Arch Surg 1989;124:445-448) SN - 0004-0010 M3 - doi: 10.1001/archsurg.1989.01410040055012 UR - http://dx.doi.org/10.1001/archsurg.1989.01410040055012 ER -