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  • Hemorrhagic shock  (3)
  • Key words Aerosols  (2)
  • 1
    ISSN: 1433-8580
    Keywords: Hemorrhagic shock ; Hemodilution ; Hemorheology ; Microcirculation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The keyproblem of hemorrhagic shock consists in decreased tissue nutrition and tissue drainage from metabolites with subsequent hypoxic cellular damage. In two groups of 50 dogs the effect of whole blood (n = 30) versus hemodilution with dextran-60 (n = 20) was evaluated from central hemodynamics, capillary blood flow and transcapillary exchange from tissue to blood in skeletal muscle by use of a double isotope technique. Following a period of hemorrhagic hypotension either all the shed blood or dextran-60 were infused. Hemodilution with dextran produced a decrease in hematocrit to 20%, lowered effeciently blood viscosity and TPR and increased cardiac output to 160% of control. Capillary blood flow and exchange were nearly doubled as compared to the control level. Retransfusion of blood caused only transient normalization with rapid deterioration in central and peripheral hemodynamics, together with an increase in blood viscosity. The viscosity depressant effect of hemodilution is discussed as key factor causing the better immediate response to dextran infusion in hemorrhagic shock.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 185 (1985), S. 21-33 
    ISSN: 1433-8580
    Keywords: Hemorrhagic shock ; Dogs ; Oxygen deficit ; Volume uptake ; Survival rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prerequisite elucidating the pathomechanism of hemorrhagic shock are reproducible experimental models, leading to a predictable outcome. Two concepts have been reported to be a good predictor for the outcome both employing a fixed hypotension level: total oxygen deficit and shed blood volume uptake. To correlate these two models we subjected 31 dogs to a standardized hemorrhagic shock procedure. Besides determination of acid-base status, hematocrit, mean arterial pressure, and cardiac output, these two parameters were measured continuously. Seventeen dogs survived the shock procedure, 14 died within 24 h. During shock, neither oxygen deficit nor any other parameter mentioned above correlated with the final outcome of the shock state. The only significant difference between surviving and non-surviving animals during this period was the amount of uptake. The non-surviving dogs exhibited a higher uptake volume, indicating an incipient collapse of the microcirculation. Terminating the duration of hypotension at an uptake volume of 5% of the maximum shed blood, all animals survived, while after an uptake volume of 15% about 50% of the dogs died. Using uptake volumes of various degrees in a hemorrhagic shock model as the endpoint of the hypotensive stress, it seems possible to produce reliable survival rates.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 185 (1985), S. 469-482 
    ISSN: 1433-8580
    Keywords: Hemorrhagic shock ; Central hemodynamics ; Regional blood flow ; Dogs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Oxygen consumption, hemodynamics, and regional blood flow (with the radioactive microspheres technique) were determined in 12 anesthetized dogs subjected to hemorrhagic shock. The animals were kept in hypotension at 40 mm Hg, until 15% of the maximum shed blood had been infused to keep arterial pressure stable, whereafter all the shed blood was retransfused. Cardiac output (CO) decreased to 33% and 25% of preshock values in survivors (S) and nonsurvivors (NS), respectively, and after retransfusion it was significantly higher in S. After retransfusion, NS showed a higher arterial pCO2 than S adding a respiratory component to the metabolic acidosis that occurred during and after hemorrhage. Blood flow to the brain was not impeded during shock, but as CO decreased the fraction delivered to the brain was increased 2.6–3.3-fold. Myocardial blood flow decreased to about 28% of preshock values immediately after hemorrhage, and increased to about 54% at the end of hemorrhage. After retransfusion S had a higher myocardial flow than NS. The flow to the gut paralleled the decrease in CO during hemorrhage and immediately after retransfusion NS exhibited an overperfusion in ileum and colon compared to the preshock values. Kidney blood flow fell progressively during the course of hypotension, similarly in S and NS. After retransfusion it was normalized in S but not in NS. The preshock flow to pancreas was significantly higher in S than in NS, but during and after shock the blood flow did not differ between S and NS.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1238
    Keywords: Key words Aerosols ; Epoprostenol ; Toxicity lung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To study potential toxic effects of long-term (8 h) inhaled prostacyclin (PGI2) on respiratory tract tissues. Design: In a prospective, randomized order, either PGI2 (n=7) or normal saline (n=7) was aerosolized during a time period of 8 h in healthy lambs. Setting: Institute for Surgical Research of the Ludwig-Maximilians University of Munich. Animals: 14 healthy, anesthetized, ventilated lambs. Interventions: All animals were endotracheally intubated followed by tracheotomy. PGI2 solution or normal saline was administered with a jet nebulizer (delivery rate 4–10 ml/h; mass median diameter of aerosol particles 3.1 μm). Measurements and results: Histomorphological changes after 8-h inhalation of PGI2 solution were compared to those after 8-h inhalation of normal saline. Tracheal and bronchoalveolar tissues were examined by light and electron microscopy in order to assess tissue damage induced by inhaled PGI2. Pathological changes were ranked by a blinded observer following a graduation system ranging from ”absence of pathological changes“ to ”maximal pathological changes“. Abnormalities were restricted to the trachea (focal flattening of the epithelium, loss of cilia, slight inflammatory cell infiltration) and alveolar tissue (focal alveolar septal thickening with slight inflammatory cell infiltration), but no statistically significant differences between the PGI2 and control groups were encountered. Conclusion: Our findings indicate the absence of PGI2 aerosol-related respiratory tissue damage after 8-h inhalation of PGI2.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1238
    Keywords: Key words Aerosols ; Epoprostenol ; Toxicity ; Lung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To study the potential side effects and toxicity of inhaling prostacyclin (PGI2) aerosol for 8 h. Design: In a prospective, randomized study 14 healthy lambs received either PGI2 (n=7) or 0.9% NaCl (n=7) as an aerosol for 8 h. Setting: Institute for Surgical Research of the Ludwig-Maximilians- University of Munich. Interventions: All animals were studied under general anesthesia in a prone position. They were first intubated endotracheally and later tracheotomized. PGI2 solution (median dose 28 ng/kg per min) or 0.9% NaCl was administered with a jet nebulizer (delivery rate 4–10 ml/h; mass median diameter of aerosol particles 3.1 μm). Bronchoalveolar lavage was performed before and after the inhalation period to collect epithelial lining fluid of alveoli. Measurements and results: Hemodynamic and respiratory parameters, systemic resorption (plasma levels of 6-keto-prostaglandin-F1α), in vitro bleeding time, collagen-induced platelet aggregation and global biochemical and cellular composition of the epithelial lining fluid were examined in order to assess the side effects and signs of acute pulmonary toxicity induced by inhaled PGI2. No statistically significant differences were found between the PGI2 and the control groups for any of the parameters examined. Conclusion: Inhalation of PGI2 (28 ng/kg per min) over a period of 8 h in healthy lambs does not produce major side effects or acute pulmonary toxicity.
    Type of Medium: Electronic Resource
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