Literature DB >> 10588514

Heart function after severe hemorrhagic shock.

J A Kline1, L R Thornton, G D Lopaschuk, R W Barbee, J A Watts.   

Abstract

OBJECTIVE: Test whether brief deep hemorrhagic hypotension or prolonged moderate hemorrhagic hypotension impairs intrinsic heart function.
METHODS: Pentobarbital-anesthetized, non-anticoagulated rats were cannulated via the carotid artery. This study focuses on three main groups: 1) hemorrhage to a mean arterial blood pressure (MAP)=25 mm Hg for 1 h (1 h severe shock), 2) hemorrhage to MAP=40 mm Hg for 3 h (3 h moderate shock), 3) no hemorrhage (control). Hearts were either freeze-clamped in-situ for tissue analysis (n=6 per group) or were removed to study in vitro cardiac function and efficiency using a working heart perfusion (n=12 per group, glucose (11 mM)/palmitate (0.4 mM), 3% BSA buffer). Following perfusion, hearts were freeze-clamped and analyzed for free CoA, acetyl-, succinyl-, and malonyl-CoA, ATP content and for TNF-alpha content.
RESULTS: Isolated working hearts obtained following 1 h of severe shock generated 20% less hydraulic work than hearts obtained from control rats or rats subjected to 3 h of moderate shock. The cardiac efficiency (work/O2 consumption) was also significantly reduced with 1 h severe shock (0.76 +/- 0.07 after 15 min perfusion) versus control (0.96 +/- 0.06) or 3 h prolonged shock (1.10 +/- 0.09). Myocardial Co-A ester, ATP and TNF-alpha concentrations were not different between control and shocked hearts, although TNF-alpha concentrations increased significantly in all hearts during ex vivo perfusion.
CONCLUSIONS: Depth of hypotension is more important than duration in causing intrinsic cardiac dysfunction. This post-hemorrhagic cardiac dysfunction is not a result of substrate limitation to the heart, nor myocardial TNF-alpha accumulation, but is more likely a result of impaired transfer of energy from molecular oxygen into external cardiac work.

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Year:  1999        PMID: 10588514     DOI: 10.1097/00024382-199912000-00007

Source DB:  PubMed          Journal:  Shock        ISSN: 1073-2322            Impact factor:   3.454


  5 in total

1.  Diastolic function during hemorrhagic shock in rabbits.

Authors:  Verónica D'Annunzio; Martín Donato; Andrea Fellet; Bruno Buchholz; Valeria G Antico Arciuch; María C Carreras; Laura B Valdez; Tamara Zaobornyj; Celina Morales; Alberto Boveris; Juan J Poderoso; Ana M Balaszczuk; Ricardo J Gelpi
Journal:  Mol Cell Biochem       Date:  2011-08-13       Impact factor: 3.396

2.  Cardiac systolic function recovery after hemorrhage determines survivability during shock.

Authors:  Surapong Chatpun; Pedro Cabrales
Journal:  J Trauma       Date:  2011-04

3.  Early physiologic responses to hemorrhagic hypotension.

Authors:  Ivo P Torres Filho; Luciana N Torres; Roland N Pittman
Journal:  Transl Res       Date:  2009-09-25       Impact factor: 7.012

4.  Role of gut-lymph factors in the induction of burn-induced and trauma-shock-induced acute heart failure.

Authors:  Marlon A Lee; Atsuko Yatani; Justin T Sambol; Edwin A Deitch
Journal:  Int J Clin Exp Med       Date:  2008-03-31

5.  Mesenteric lymph duct ligation prevents trauma/hemorrhage shock-induced cardiac contractile dysfunction.

Authors:  Justin T Sambol; Marlon A Lee; Francis J Caputo; Kentaro Kawai; Chirag Badami; Tomoko Kawai; Edwin A Deitch; Atsuko Yatani
Journal:  J Appl Physiol (1985)       Date:  2008-11-13
  5 in total

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