Abstract
Objective: to study the specific features of skin blood flow changes in blood loss and after its replacement. Material and methods . Experiments were carried out on 22 outbred male rats weighing 400—550 g, anesthetized with nembutal or chloralhydrate. The caudal artery was catheterized to measure blood pressure (BP), to sample and reinfuse blood. Skin blood flow in the area of the right ear was recorded by laser Doppler flowmetry. Onehour hypovolemic hypotension followed by autoblood reinfusion served as a model. Blood loss volume necessitated maintenance of BP at about 50 mm Hg by 60 minutes of hypotension. The investigators deter mined the following indicators of skin blood flow: microcirculatory index (MI) and relative perfusion units (pf. u); a wavelet method was used to estimate the maximum amplitudes of blood flow fluctuations (flux motions) in the ranges accepted to be correlated with active and passive mechanisms to regulate microcirculation. The data were statistically processed by applying the Statistica 7.0 program. The results were presented as Me (25%; 75%). Results . The animals were divided into groups according to blood loss volume: lower (L) and higher (H) than average. At 60 minutes of hypotension, BP in both groups averaged 53 mm Hg, but the L group showed a tendency (p<0.1) towards a greater MI and a longer mplitude of flux motions in the neurogenic (An) and additional (Aa) frequency ranges (p<0.05) than in the H group. At 60 minutes of blood reinfusion, all the analyzed indicators returned to the base line values (except a tendency (p<0.1) towards a lower MI) in the H group while BP remained below the baseline value in the L group. In the same followup period, the amplitudes of flux motions in the An and Aa ranges were higher and MI and BP were lower in the L group than in the H group (p<0.05). Conclusion. During hypovolemic hypotension and reinfusion, the increased amplitude of flux motions involves an animal's individual and typological capacity to compensate blood loss and to maintain blood flow under tissue hypoperfusion.
Highlights
Геморрагический шок является разновидностью гиповолемического шока и возникает при значитель ном уменьшении объема циркулирующей крови в ре зультате кровопотери
Animals were administered with polyethylene catheters through the tail artery for invasive measurement of blood pressure, blood shedding and blood infusion
It turned out that in the initial state the chloralhydrate leads to a decrease in blood pres sure and index of perfusion (IP) (Table 1)
Summary
Геморрагический шок является разновидностью гиповолемического шока и возникает при значитель ном уменьшении объема циркулирующей крови в ре зультате кровопотери. В основе патогенеза геморраги ческого и других видов шока лежат грубые расстройства кровообращения (системной гемодина мики и микроциркуляции), приводящие к снижению перфузии и оксигенации тканей, их гипоксии и перехо ду аэробного метаболизма в анаэробный. Состояние микроциркуляции непосредственно влияет на адекватность перфузии и оксигенации тка ней, восстановление которых все чаще рассматривается как главная цель интенсивной терапии шока и других критических состояний [7,8,9]. Что выраженность ишемических и реперфу зионных повреждений в значительной степени опреде ляется сроками, объемом и качественным составом проводимой инфузионно трансфузионной терапии, а также исходным состоянием организма
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