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Effects of primary resuscitation from shock on distribution of myocardial blood flow.

Abstract
Hemorrhagic shock alters heterogeneity of regional myocardial perfusion (RMP) in the presence of critical coronary stenosis in pigs. Conventional resuscitation has failed to reverse these effects. We hypothesized that improvement of the resuscitation regime would lead to restoration of RMP heterogeneity. Diaspirin-cross-linked hemoglobin (10 g/dl; DCLHb) and human serum albumin (8.0 g/dl; HSA) were used. After baseline, a branch of the left coronary artery was stenosed; thereafter, hemorrhagic shock was induced. Resuscitation was performed with either DCLHb or HSA. At baseline, the fractcal dimension (D) of subendocardial myocardium was 1.31 +/- 0.083 (HSA) and 1.35 +/- 0.106 (DCLHb) (mean +/- SD). Coronary stenosis increased subendocardial D slightly but consistently only in the DCLHb group (1.39 +/- 0.104; P < 0.05). Shock reduced subendocardial D: 1.21 +/- 0.093 (HSA; P = 0.10), 1.25 +/- 0.092 (DCLHb; P < 0.05). Administration of DCLHb increased subendocardial D in 7 of 10 animals (1.31 +/- 0.097; P = 0.066). HSA was ineffective in this respect. DCLHb infusion restored arterial pressure and increased cardiac index (CI) to 80% of baseline values. Administration of HSA left animals hypotensive (69 mmHg) and increased CI to 122% of the average baseline value. Shock-induced disturbances of the distribution of RMP were improved by administration of DCLHb but not by HSA.
AuthorsM Kleen, O Habler, F Meisner, G Kemming, A Pape, K Messmer
JournalJournal of applied physiology (Bethesda, Md. : 1985) (J Appl Physiol (1985)) Vol. 88 Issue 2 Pg. 373-85 (Feb 2000) ISSN: 8750-7587 [Print] United States
PMID10658001 (Publication Type: Journal Article)
Chemical References
  • Hemoglobins
  • Serum Albumin
  • diaspirin-cross-linked hemoglobin
  • Aspirin
Topics
  • Animals
  • Aspirin (analogs & derivatives, pharmacology)
  • Coronary Circulation (drug effects, physiology)
  • Coronary Vessels (drug effects, physiopathology)
  • Hemodynamics (drug effects, physiology)
  • Hemoglobins (pharmacology)
  • Humans
  • Hypotension (etiology)
  • Middle Aged
  • Resuscitation
  • Serum Albumin (adverse effects, pharmacology)
  • Shock, Hemorrhagic (physiopathology, therapy)
  • Swine

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