Myocardial blood flow heterogeneity in shock and small-volume resuscitation in pigs with coronary stenosis

Author:

Kleen Martin12,Welte Martin12,Lackermeier Peter12,Habler Oliver12,Kemming Gregor2,Messmer Konrad1

Affiliation:

1. Institute for Surgical Research and

2. Institute of Anesthesiology, University of Munich, 81366 Munich, Germany

Abstract

Kleen, Martin, Martin Welte, Peter Lackermeier, Oliver Habler, Gregor Kemming, and Konrad Messmer. Myocardial blood flow heterogeneity in shock and small-volume resuscitation in pigs with coronary stenosis. J. Appl. Physiol.83(6): 1832–1841, 1997.—We analyzed the effects of shock and small-volume resuscitation in the presence of coronary stenosis on fractal dimension ( D) and spatial correlation (SC) of regional myocardial perfusion. Hemorrhagic shock was induced and maintained for 1 h. Pigs were resuscitated with hypertonic saline-dextran 60 [HSDex, 10% of shed blood volume (SBV)] or normal saline (NS; 80% of SBV). Therapy was continued after 30 min with dextran (10% SBV). At baseline, D was 1.39 ± 0.06 (mean ± SE; HSDex group) and 1.34 ± 0.04 (NS group). SC was 0.26 ± 0.07 (HSDex) and 0.26 ± 0.04 (NS). Left anterior descending coronary artery stenosis changed neither D nor SC. Shock significantly reduced D(i.e., homogenized perfusion): 1.26 ± 0.06 (HSDex) and 1.23 ± 0.05 (NS). SC was increased: 0.41 ± 0.1 (HSDex) and 0.48 ± 0.07 (NS). Fluid therapy with HSDex further decreased D to 1.22 ± 0.05, whereas NS did not change D. SC was increased by both HSDex (0.56 ± 0.1) and NS (0.53 ± 0.06). At 1 h after resuscitation, SC was constant in both groups, and D was reduced only in the NS group (1.18 ± 0.02). We conclude that hemorrhagic shock homogenized regional myocardial perfusion in coronary stenosis and that fluid therapy failed to restore this.

Publisher

American Physiological Society

Subject

Physiology (medical),Physiology

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