Effects of different infusion volumes on hemodynamics of portal hypertension canines after hemorrhagic shock. 2004

Xiao-Qing Li, and Lei Dong, and Jin-Yan Luo
Department of Gastroenterology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, China. goodlxq@sina.com

BACKGROUND Portal hypertension (PHT) with upper gastrointestinal hemorrhage as its chief complication is a very common disease with great harm to humans. The effects of infusion volume, speed, and type on hemodynamics in case of cirrhosis, PHT esophageal variceal bleeding, and their mechanism should be clarified. This study was designed to assess the effects of different infusion volumes on hemodynamics of PHT canines after hemorrhagic shock (HS). METHODS PHT canine models were made by chronic embolization via coarctating half of the main portal vein with silk suture. Two weeks later, the models were subjected to hemorrhagic shock by quick femoral artery venesection. The canines were divided into two groups to resuscitate: one to receive a large volume of infusion (n=6) (large volume infusion group) and the other to receive a small volume of infusion (n=6) (small volume infusion group). Hemodynamic indexes of PHT canines after HS and infusion were observed closely. RESULTS The PHT canines showed a series of hemodynamical changes in hemorrhagic shock stage, which aggravated hemodynamical disorder in PHT. After quick infusion, mean arterial pressure (MAP), inferior vena cava pressure (IVCP), portal venous pressure (PVP), portal vein pressure gradient (PVPG), portal vein blood flow (PVBF), hepatic artery blood flow (HABF) and hepatic blood flow (HBF) increased significantly. These indexes in the large volume infusion group were higher than those in the small volume infusion group. Portal vascular resistance (PVR), splanchnic vascular resistance (SVR), hepatic arterial resistance (HAR) decreased significantly, but PVP, PVPG, PVBF, HABF and HBF showed a rebounding increase above the baseline values in the large volume infusion group. The changes of PVP, PVPG, PVBF, HABF and HBF were in parallel with those of MAP and inferior vena cava pressure (IVCP), without a rebounding increase in the small volume infusion group. In the large volume infusion group PVPG increased earlier and more significantly than did PVP; moreover PVPG exceeded the baseline by 13%, making the possibility of rebleeding great. In the small volume infusion group, PVPG was lower than the baseline by more than 22%, indicating a small possibility of rebleeding. SVR and HAR were lower in the large volume infusion group. PVP, PVPG, PVBF, HABF and HBF were positively correlated with accumulated volume of vein infusion. PVR showed a positive correlation with accumulated volume of vein infusion in the small volume infusion group. HAR was negatively correlated with accumulated volume of vein infusion in the large volume infusion group. CONCLUSIONS PHT canines after HS, resuscitated by vein infusion, may show a rebounding increase of PVP, PVPG, PVBF, HABF and HBF above the baseline values in the large volume infusion group but not in the small volume infusion group. A large volume infusion causes PVP, PVPG, PVBF, HABF and HBF to increase higher than does a small volume infusion.

UI MeSH Term Description Entries
D006975 Hypertension, Portal Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN. Cruveilhier-Baumgarten Disease,Cruveilhier-Baumgarten Syndrome,Cruveilhier Baumgarten Disease,Cruveilhier Baumgarten Syndrome,Disease, Cruveilhier-Baumgarten,Portal Hypertension,Portal Hypertensions,Syndrome, Cruveilhier-Baumgarten
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D011169 Portal Vein A short thick vein formed by union of the superior mesenteric vein and the splenic vein. Portal Veins,Vein, Portal,Veins, Portal
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D012771 Shock, Hemorrhagic Acute hemorrhage or excessive fluid loss resulting in HYPOVOLEMIA. Hemorrhagic Shock
D014690 Venous Pressure The blood pressure in the VEINS. It is usually measured to assess the filling PRESSURE to the HEART VENTRICLE. Blood Pressure, Venous,Blood Pressures, Venous,Pressure, Venous,Pressure, Venous Blood,Pressures, Venous,Pressures, Venous Blood,Venous Blood Pressure,Venous Blood Pressures,Venous Pressures

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