Renal oxygen and lactate metabolism in hemorrhagic shock. An experimental study. 1984

O Nelimarkka

Renal oxygen and lactate metabolism as well as central and renal hemodynamics were investigated in hemorrhagic shock in dogs. The animals were bled progressively until a 40-50% blood loss was achieved. Following a 20-, 40-, 60-, or 80-minute shock phase the shed blood was gradually returned. The effect of acute total ischemia on renal oxygen metabolism was studied during arterial occlusion. The renal cortical and medullary PO2 and PCO2 were recorded by means of implanted Silastic tonometers. The mean baseline cortical PO2 was 35 mmHg and the corresponding medullary PO2 25 mmHg. The renal cortical PO2 responded promptly to hemorrhage and declined in parallel with the cardiac output and renal blood flow. Hypoxia became more severe in the cortex than in the medulla during hemorrhagic shock. The response of both the cortical and the medullary PO2 to blood return increased with prolongation of the preceding shock phase. After one hour of shock, or more, the tissue oxygen tensions exceeded the prehemorrhage levels. Concomitantly, the renal blood flow and oxygen consumption were depressed below the initial values. The results of the studies of tissue PO2 decay curves after renal arterial occlusion suggested that the mean critical PO2 level for oxygen consumption is 15 mmHg for the cortex and 13 mmHg for the medulla. Aerobic oxidative metabolism ceased at a PO2 value of 6 mmHg in both tissue layers. In hemorrhagic shock, the critical PO2 level for oxygen consumption was reached earlier in the cortex than in the medulla. The minimum PO2 for aerobic oxidative metabolism was recorded in the cortex during severe shock, but not in the medulla. Renal lactate uptake remained rather unaffected during graded hemorrhage. The extreme impairment of renal perfusion associated with hemorrhagic shock produced a parallel decrease in the cortical PO2 and lactate utilization. Renal lactate utilization became limited at the cortical PO2 level, which coincided with the critical PO2 measured during the arterial occlusion. Lactate utilization ceased at a cortical PO2 level that was analogous with the minimum PO2 for aerobic oxidative metabolism determined after arterial occlusion. After reinfusion of shed blood renal lactate uptake failed to return to the prehemorrhage level. The renal lactate uptake was inversely related to the arterial pH under baseline conditions whereas after blood return the correlation between these parameters was less significant. The present findings suggest that in hemorrhagic shock renal metabolism may become limited by hypoxia and the susceptibility to the development of hypoxia is greater in the cortex than in the medulla.(ABSTRACT TRUNCATED AT 400 WORDS)

UI MeSH Term Description Entries
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D007773 Lactates Salts or esters of LACTIC ACID containing the general formula CH3CHOHCOOR.
D008297 Male Males
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D010313 Partial Pressure The pressure that would be exerted by one component of a mixture of gases if it were present alone in a container. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Partial Pressures,Pressure, Partial,Pressures, Partial
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D012077 Renal Artery A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters. Arteries, Renal,Artery, Renal,Renal Arteries
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
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic

Related Publications

O Nelimarkka
January 1981, Anesteziologiia i reanimatologiia,
O Nelimarkka
June 1998, Journal of anesthesia,
O Nelimarkka
January 1995, Revista do Hospital das Clinicas,
O Nelimarkka
January 1969, Minnesota medicine,
O Nelimarkka
May 2002, Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA,
O Nelimarkka
November 1978, The American journal of physiology,
O Nelimarkka
September 1972, The Journal of bone and joint surgery. American volume,
Copied contents to your clipboard!