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.