Cremaster muscle perfusion, oxygenation, and heterogeneity revealed by a new automated acquisition system in a rodent model of prolonged hemorrhagic shock

Abstract

Local blood flow/oxygen partial pressure (Po2) distributions and flow-Po2 relationships are physiologically relevant. They affect the pathophysiology and treatment of conditions like hemorrhagic shock (HS), but direct noninvasive measures of flow, Po2, and their heterogeneity during prolonged HS are infrequently presented. To fill this void, we report the first quantitative evaluation of flow-Po2 relationships and heterogeneities in normovolemia and during several hours of HS using noninvasive, unbiased, automated acquisition. Anesthetized rats were subjected to tracheostomy, arterial/venous catheterizations, cremaster muscle exteriorization, hemorrhage (40% total blood volume), and laparotomy. Control animals equally instrumented were not subjected to hemorrhage/laparotomy. Every 0.5 h for 4.5 h, noninvasive laser speckle contrast imaging and phosphorescence quenching were employed for nearly 7,000 flow/Po2 measurements in muscles from eight animals, using an automated system. Precise alignment of 16 muscle areas allowed overlapping between flow and oxygenation measurements to evaluate spatial heterogeneity, and repeated measurements were used to estimate temporal heterogeneity. Systemic physiological parameters and blood chemistry were simultaneously assessed by blood samplings replaced with crystalloids. Hemodilution was associated with local hypoxia, but increased flow prevented major oxygen delivery decline. Adding laparotomy and prolonged HS resulted in hypoxia, ischemia, decreased tissue oxygen delivery, and logarithmic flow/Po2 relationships in most regions. Flow and Po2 spatial heterogeneities were higher than their respective temporal heterogeneities, although this did not change significantly over the studied period. This quantitative framework establishes a basis for evaluating therapies aimed at restoring muscle homeostasis, positively impacting outcomes of civilian and military trauma/HS victims. NEW & NOTEWORTHY This is the first study on flow-Po2 relationships during normovolemia, hemodilution, and prolonged hemorrhagic shock using noninvasive methods in multiple skeletal muscle areas of monitored animals. Automated flow/Po2 measurements revealed temporal/spatial heterogeneities, hypoxia, ischemia, and decreased tissue oxygen delivery after trauma/severe hemorrhage. Hemodilution was associated with local hypoxia, but hyperemia prevented a major decline in oxygen delivery. This framework provides a quantitative basis for testing therapeutics that positively impacts muscle homeostasis and outcomes of trauma/hemorrhagic shock victims.

Effects of hypobaric hypoxia during a simulated ultra‐long‐haul flight on inflammation and regeneration after muscle trauma and muscle trauma‐hemorrhagic shock

“…37 Another reason we expected differences between MT and PT mice is hemorrhagic shock reduces muscle O 2 levels. 38,39 One explanation may be that muscle leukocyte and regeneration responses may tolerate the temporary hypoxia induced by muscle injury and hemorrhagic shock combined. Muscle, like other tissue, has an O 2 level approximately three-fold lower ($5% O 2 ) than in arterial blood (12% O 2 ).…”

Effects of impaired microvascular flow regulation on metabolism‐perfusion matching and organ function

“…23 Conditions resulting in lowered hematocrit such as hemorrhagic shock can lead to increased temporal and spatial heterogeneity, particularly following fluid resuscitation. 24,25 Spontaneous oscillations in vessel diameter, termed vasomotion, can redistribute blood flow and may affect oxygen transport. 26,27 As measured by Poole and colleagues in skeletal muscle using phosphorescence quenching, a substantial oxygen gradient exists between the microvasculature and the interstitium, 28,29 highlighting the importance of a homogeneous red blood cell distribution in maintaining adequate supply to tissues with high demand.…”

“…With hemodilution, 22 anemia, or other pathophysiological conditions, some microvessels may receive few or no red blood cells, leading to hypoxia 23 . Conditions resulting in lowered hematocrit such as hemorrhagic shock can lead to increased temporal and spatial heterogeneity, particularly following fluid resuscitation 24,25 . Spontaneous oscillations in vessel diameter, termed vasomotion, can redistribute blood flow and may affect oxygen transport 26,27 .…”