Effect of Blood and Saline Infusion on Cardiac Performance in Normal Dogs and Dogs with Arteriovenous Fistulas

Abstract

Maximum left ventricular work response (and other hemodynamic changes) to infusion of saline and whole blood was compared in normal dogs and in dogs with aorta-caval and multiple peripheral fistulas. In the dogs with fistulas the augmented preinfusion levels of cardiac work and left ventricular end-diastolic pressure approximated those in normal dogs after maximum response to infusion. Following infusion in the dogs with fistulas, end-diastolic pressure characteristically increased but cardiac work did not. Thus maximum cardiac work was of the same order of magnitude in the normal dogs and in the dogs with fistulas. In all groups maximum left ventricular work was effected mainly through an increased cardiac output.

The Hemodynamic Response to Lanatoside C of Dogs with Experimental Aortic-Caval Fistulas

“…Some animals developed edema of the fore-limbs as well as the hind-limbs, and a number of the dogs died of pulmonary edema which is highly indicative of cardiac failure under these circumstances. The maximum cardiac work levels in these preparations were similar to those obtained in normal dogs with massive infusion of blood or saline (1). The left ventricular end-diastolic pressure was consistently elevated in the fistula group, the lowest value being 13 mm.…”

“…Previous work has demonstrated that a severe burden is placed on the circulatory system of the dog by the surgical production of a long-sustained aortic-caval fistula (1). Circulatory distress is manifested by ascites, edema of all extremities and the lungs, together with a marked rise in left ventricular end-diastolic pressure, cardiac output, cardiac work, heart rate, and a depression of total peripheral resistance.…”

“…Circulatory distress is manifested by ascites, edema of all extremities and the lungs, together with a marked rise in left ventricular end-diastolic pressure, cardiac output, cardiac work, heart rate, and a depression of total peripheral resistance. The heart is at or near a state of cardiac decompensation, as indicated by the level of cardiac work and the response of the circulatory system to the infusion of whole blood or saline (1). Such infusions generally cause the cardiac output and cardiac work to decline and the left ventricular end-diastolic pressure to rise further, while the maximum level of cardiac work attained before infusion approximates that in the normal dog with massive infusion (1).…”

“…The heart is at or near a state of cardiac decompensation, as indicated by the level of cardiac work and the response of the circulatory system to the infusion of whole blood or saline (1). Such infusions generally cause the cardiac output and cardiac work to decline and the left ventricular end-diastolic pressure to rise further, while the maximum level of cardiac work attained before infusion approximates that in the normal dog with massive infusion (1). To obtain further information on the physiological state of these dogs their response to rapid digitalization has been determined.…”

Left ventricular function in experimental aorto-caval fistula with circulatory congestion and fluid retention

“…In man the cardiac output, heart rate, and right atrial pressure are elevated, arterial pulse pressure is increased (1)(2)(3)(4), and the blood volume is expanded (5). Similar effects have been observed in the dog with an experimentally induced fistula (6)(7)(8)(9)(10), and a reduction in peripheral blood flow (7) and renal blood flow (10) also has been observed. In addition, maximum cardiac output, attainable by transfusion, may be greater in dogs with an arteriovenous shunt than in normal dogs, whereas the maximum stroke work is less (8).…”