Blood Volume Redistribution During Cross-Clamping of the Descending Aorta

Abstract

We tested the hypothesis that occlusion of the descending aorta is associated with blood volume redistribution resulting in a relative hypervolemia in organs and tissues proximal to the level of occlusion. The study was performed on splenectomized dogs anesthetized with pentobarbital. Whole body scintigraphy with a Sophy DSX rectangular large field of view gamma-camera equipped with a high resolution collimator was used; Tc99m was used to label plasma albumin. The aorta was occluded at diaphragmatic and suprarenal levels in random order. The activity was counted during different stages of the experiments in the following regions of interest: brain, left and right ventricles, left and right lungs, left and right deltoid muscles, the liver, and intestines. Cross-clamping at the suprarenal level was not associated with significant changes in blood volume in any region of interest. The aortic cross-clamping at diaphragmatic level was associated with significant increases in the gamma-emission in all organs and tissues above the level of aortic occlusion by 8%-38%. Thus, the present study supports the hypothesis by demonstrating that cross-clamping of the aorta at diaphragmatic level is associated with an increase in blood volume in the organs and tissues proximal to the level of cross-clamping. Such an increase might represent the mechanism for well-documented increases in preload and blood flow above aortic occlusion, resulting in an additional (in addition to an increase in afterload) burden to the heart.