| Dynamic changes in shunt and ventilation-perfusion mismatch following experimental pulmonary contusion. | |
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MedLine Citation:
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PMID: 20407408 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The objective of this study was to investigate early changes in oxygenation by means of the multiple inert gas elimination technique and in coagulation by means of thromboelastography (TEG) after right-sided pulmonary contusion (PC) in swine. Anesthetized swine (group 1; n = 8) sustained a right-chest PC by a captive-bolt stunner. Multiple inert gas elimination technique, TEG, and thoracic computed tomography (CT) scans were performed before and 10, 30, 60, and 120 min after injury. Three-dimensional CT scan reconstruction enabled measurement of volumes of poorly (Vol(Poor)) and nonaerated (Vol(Non)) lung. Eight animals (group 0) were used as uninjured controls. Pulmonary contusion led to sustained tachycardia and transient hypotension. Partial pressure of arterial oxygen (PaO2) decreased from 83.9 +/- 4.2 mmHg at baseline to 51.3 +/- 2.8 mmHg 10 min after PC (P < 0.001). Vol(Poor) and Vol(Non) on the right increased significantly after PC, followed by gradual progression in injury marked by decreased Vol(Poor) and increased Vol(Non). By the multiple inert gas elimination technique, blood flow to the true shunt compartment increased from 4.4% +/- 1.0% at baseline to 21.2% +/- 4.9% 10 min after PC, P < 0.001, peaked at 33.2% +/- 7.5% 30 min after PC, P < 0.001, and remained significantly higher compared with controls. Transient increase in blood flow to low and very low ventilation-perfusion (V/Q) compartments was also seen. Clot reaction time and formation rate by TEG increased at 2 h after PC. True shunt is the major cause of hypoxemia after PC, but V/Q mismatch also contributes significantly early after injury. By CT, PC leads to significant loss of functional lung volume on the side of injury. A mild hypocoagulable state was identified 2 h after injury. |
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Authors:
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Andriy I Batchinsky; Bryan S Jordan; Corina Necsoiu; Michael A Dubick; Leopoldo C Cancio |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Shock (Augusta, Ga.) Volume: 33 ISSN: 1540-0514 ISO Abbreviation: Shock Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-21 Completed Date: 2010-07-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9421564 Medline TA: Shock Country: United States |
Other Details:
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Languages: eng Pagination: 419-25 Citation Subset: IM |
Affiliation:
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US Army Institute of Surgical Research, 3400 Rawley E. Chambers Avenue, Building 3611, Fort Sam Houston, Texas 78234-6315, USA. andriy.batchinsky@amedd.army.mil |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Contusions / physiopathology* Female Heart Rate Lung Injury / physiopathology* Oxygen / blood* Pulmonary Circulation Radiography, Thoracic Swine Thrombelastography Tomography, X-Ray Computed Ventilation-Perfusion Ratio / physiology* |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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