Articles: splanchnic-circulation-physiology.
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Free Radic. Biol. Med. · Aug 1994
Comparative StudyComparative evaluation of the acute effects of oxygen free radicals on myocardial contractility in anesthetized dogs with those occurring in the early stages of splanchnic artery occlusion and hemorrhagic shock.
Oxygen free radicals are cytotoxic and generated in excessive quantities during reoxygenation of ischemic organs. It has been demonstrated that oxygen free radicals impair cardiac contractile mechanisms in in vitro studies as well as depress myocardial contractility in in vivo experiments. The objectives of the present studies are to evaluate alterations in cardiac contractility and hemodynamics in two canine models of shock, namely, Wigger's model of hemorrhage and splanchnic artery occlusion (SAO) model. ⋯ However, in both the models, after reinfusion of the blood (Wigger's) or after release of splanchnic arteries, there were gradual deteriorations of stroke volume, cardiac output, and arterial blood pressure. In contrast, after generation of free radicals by exogenous administration of xanthine plus xanthine oxidase, cardiac contractility was significantly depressed leading to decreases in stroke volume, cardiac output, and blood pressure. Using identical procedures to evaluate contractility, we have demonstrated that the initial depression of myocardial contractility was not the causative factor for circulatory failure in the two models of shock.(ABSTRACT TRUNCATED AT 250 WORDS)
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The effect of anesthesia on splanchnic blood flow was examined during hemorrhagic shock and resuscitation. Sprague-Dawley rats were anesthetized with the inhalation anesthetic, methoxyflurane, or pentobarbital (65 mg/kg). Transonic Doppler flow probes were placed around the superior mesenteric artery (SMA) and the abdominal aorta, and the animals were subjected to acute hemorrhage (or sham) to 30 mmHg for 90 min followed by 30 min of resuscitation with shed blood (n = 6/group). ⋯ Acute hemorrhage decreased SMA blood flow by 94.5 +/- 0.01 and 86.0 +/- 2.8%, respectively, in the pentobarbital and methoxyflurane groups, with similar changes occurring in aortic blood flow. During resuscitation, arterial pressure remained significantly depressed and SMA blood flow decreased by 65% in the pentobarbital group, whereas blood pressure returned to control levels and SMA blood flow increased to 56% of control values (P < 0.001) in the methoxyflurane group. The findings indicate that the choice of anesthetic agent may significantly impact splanchnic blood flow and needs to be taken into account when designing experiments examining effects of hemorrhagic shock.
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To investigate the importance of splanchnic ischemia in patients with acute circulatory failure by comparing gastric intramucosal pH as measured by tonometry with conventional methods of assessing adequacy of tissue oxygenation. ⋯ Gastric intramucosal pH was the most reliable indicator of adequacy of tissue oxygenation in this group of patients. Inadequate regional blood flow as detected by a reduction in gastric intramucosal pH, but not by systemic measures, is an important contributor to morbidity and mortality in intensive care units.
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To provide an overview of the splanchnic hemodynamic response to circulatory shock. ⋯ While angiotensin II has been viewed primarily as the mediator responsible for the increased total vascular resistance seen during (and after) cardiopulmonary bypass, it may also cause the disproportionate decrease in mesenteric perfusion, as measured in human subjects by intraluminal gastric tonometry and galactose clearance by the liver, as well as the consequent development of the multiple organ failure syndrome seen in 1% to 5% of patients after cardiac surgery.
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BACKGROUND AND METHODS. Rapid changes in cardiac output (CO) and organ perfusion occur with hemorrhagic shock and fluid resuscitation. To assess regional alterations of flow, 40 Sprague-Dawley male rats were subjected to hemorrhagic shock and crystalloid resuscitation under halothane anesthesia. Polyethylene microspheres were injected before and after hemorrhage and after resuscitation. At sacrifice, brain, lungs, heart, liver, intestine, spleen and kidneys were harvested, weighed and radioactivity counted. Changes in mean arterial pressure, oxygen consumption, organ flow and CO were also measured. ⋯ Following hemorrhage there is hypoperfusion of all splanchnic organs; however, flow to the liver decreases least. Crystalloid resuscitation in our model failed to return CO to baseline. Blood supply to intestine remained depressed in disproportion to CO both after hemorrhage and resuscitation and hepatic blood flow remained decreased after resuscitation.