Efficacy of prostaglandin E 1 in combination with volume replacement therapy in the treatment of hemorrhagic shock in dogs

Abstract

Objective: The aim of the present study was to assess the effects of prostaglandin E 1 (PGE 1) on hemodynamic and splanchnic blood flow in a canine model of hemorrhagic shock and volume replacement therapy. Methods: Hemorrhagic shock was induced in 14 anesthetized dogs by withdrawing blood into a reservoir until the mean arterial pressure stabilized at 50 mm Hg for 30 minutes. During oligemia, the drawn blood was stored at room temperature in plastic bags containing citrate-phosphate-dextrose solution. The shock period was then terminated and the remainder of the drawn blood was reinfused within a 2-minute period. The dogs were divided into 2 equal groups. Group P received PGE 1 0.1 μg/kg per minute; group S received saline in an amount equal to the diluent in group P (0.6 mL/kg per hour). The efficacy of both therapies in maintaining hemodynamic variables and splanchnic blood flow (renal cortex, renal medulla, liver, and pancreas) was investigated over 180 minutes. Splanchnic blood flow was determined by the hydrogen gas clearance method. Results: Sixty to 180 minutes after resuscitation, the cardiac index and left ventricular stroke work index values in group P were significantly greater than those in group S ( P < 0.05), and systemic vascular resistance in group P was significantly lower than that in group S during the resuscitative period ( P < 0.05). Splanchnic organ blood flow decreased significantly with hemorrhagic shock. Splanchnic blood flow to all organs in group P returned to baseline values when resuscitative therapy was performed, but the values in group S were decreased significantly compared with baseline despite resuscitation ( P < 0.05). Moreover, all splanchnic blood flow values were significantly greater in group P than in group S. Conclusions: The results of this study in dogs demonstrate that PGE 1 added to volume replacement therapy is a useful adjuvant with respect to hemodynamic and splanchnic recovery in hemorrhagic shock.