| Aortic cross-clamping and reperfusion in pigs reduces microvascular oxygenation by altered systemic and regional blood flow distribution. | |
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MedLine Citation:
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PMID: 20584875 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In this study, we tested the hypothesis that aortic cross-clamping (ACC) and reperfusion cause distributive alterations of oxygenation and perfusion in the microcirculation of the gut and kidneys despite normal systemic hemodynamics and oxygenation. METHODS: Fifteen anesthetized pigs were randomized between an ACC group (n = 10), undergoing 45 minutes of aortic clamping above the superior mesenteric artery, and a time-matched sham surgery control group (n = 5). Systemic, intestinal, and renal hemodynamics and oxygenation variables were monitored during 4 hours of reperfusion. Microvascular oxygen partial pressure (microPo(2)) was measured in the intestinal serosa and mucosa and the renal cortex, using the Pd-porphyrin phosphorescence technique. Intestinal luminal Pco(2) was determined by air tonometry and the serosal microvascular flow by orthogonal polarization spectral imaging. RESULTS: Organ blood flow and renal and intestinal microPo(2) decreased significantly during ACC, whereas the intestinal oxygen extraction and Pco(2) gap increased. The intestinal response to reperfusion after ACC was a sustained reactive hyperemia but no such effect was seen in the kidney. Despite a sustained high intestinal O(2) delivery, serosal microPo(2) (median [range], 49 mm Hg [41-67 mm Hg] versus 37 mm Hg [27-41 mm Hg]; P < 0.05 baseline versus 4 hours reperfusion) and the absolute number of perfused microvessels decreased along with an increased intestinal Pco(2) gap (17 mm Hg [10-19 mm Hg] versus 23 mm Hg [19-30 mm Hg]; P < 0.05). In contrast, the kidney showed a progressive O(2) delivery decrease accompanied by a decrease in renal cortex oxygenation (70 mm Hg [52-93 mm Hg] versus 57 mm Hg [33-64 mm Hg]; P < 0.05). CONCLUSION: Increased systemic and regional blood flow and oxygen supply after ACC does not ensure adequate regional blood flow and microcirculatory oxygenation in all organs. |
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Authors:
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Martin Siegemund; Jasper van Bommel; Michiel E Stegenga; Wolfgang Studer; Mat van Iterson; Sandra Annaheim; Alexandre Mebazaa; Can Ince |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-28 |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 111 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-28 Completed Date: 2010-08-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 345-53 Citation Subset: AIM; IM |
Affiliation:
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Department Anaesthesia and Critical Care Medicine, University Hospital, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland. siegemundm@uhbs.c |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Aorta / surgery* Carbon Dioxide / blood Constriction Disease Models, Animal Hyperemia / blood, physiopathology Ileum / blood supply* Kidney / blood supply* Male Microcirculation* Oxygen / blood* Partial Pressure Regional Blood Flow Renal Circulation* Reperfusion* Reperfusion Injury / blood, etiology, physiopathology* Splanchnic Circulation* Swine Time Factors |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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