| Haemodynamic effects of volume resuscitation by hypertonic saline-dextran (HSD) in porcine acute cardiac tamponade. | |
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MedLine Citation:
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PMID: 14674973 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hypertonic saline-dextran (HSD) has been utilized for small-volume resuscitation in acute circulatory shock. However, HSD has also been reported to induce myocardial depression. The aim of this study was to examine the effects of HSD on cardiac performance and splanchnic perfusion in a low cardiac output model based on experimental cardiac tamponade. METHODS: Seven anaesthetized, mechanically ventilated pigs of both sexes (weight 24 +/- 2 kg, mean +/- SEM) completed a randomized, cross-over protocol. A low cardiac output state was established by intrapericardial infusion of dextran. Animals were resuscitated by bolus infusions (4 ml kg(-1) in 2 min) of either 7.5% hypertonic saline-dextran or Ringer's acetated solution (RAc) and then observed during tamponade (20 min) and following its release (40 min). Central haemodynamics, portal venous (QPV) and renal arterial (QRA) flows were measured together with gastric, jejunal, hepatic and renal laser-Doppler flowmetry. RESULTS: Resuscitation using HSD in a low cardiac output state completely restored QPV and improved gastric, jejunal, hepatic and renal microcirculation as assessed by laser-Doppler flowmetry while no significant effect was observed in QRA. No such beneficial effects could be observed when animals were resuscitated using RAc. The improved haemodynamic state by HSD was maintained following release of cardiac tamponade while perfusion in RAc resuscitated animals returned to baseline or even remained depressed (hepatic and renal microcirculation). No signs of cardiodepression by HSD were observed. CONCLUSION: Resuscitation using HSD in a low cardiac output state restored splanchnic perfusion and microcirculation without any signs of cardiodepression. |
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Authors:
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K Terajima; A Aneman; H Haljamäe |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 48 ISSN: 0001-5172 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2004 Jan |
Date Detail:
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Created Date: 2003-12-16 Completed Date: 2004-04-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: Denmark |
Other Details:
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Languages: eng Pagination: 46-54 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia Animals Blood Volume / drug effects* Cardiac Tamponade / physiopathology* Cardiopulmonary Resuscitation* Dextrans / pharmacology* Female Hemodynamics / physiology* Laser-Doppler Flowmetry Male Plasma Substitutes / pharmacology* Portal Vein / drug effects, physiology Renal Circulation / drug effects Saline Solution, Hypertonic / pharmacology* Splanchnic Circulation / drug effects Swine |
| Chemical | |
Reg. No./Substance:
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0/Plasma Substitutes; 0/Saline Solution, Hypertonic; 9004-54-0/Dextrans |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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