Hematocrit and metabolic changes caused by varied resuscitation strategies in a canine model of hemorrhagic shock

Glick, Yitzchak A.; Wilson, Lance D.; Aiello, James

doi:10.1053/ajem.2002.32647

Cited by 19 publications

(9 citation statements)

References 30 publications

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“…Emerging data from experimental studies [7,17] show that aggressive fluid resuscitation in hemorrhagic shock could worsen bleeding with uncontrolled hemorrhages and also indicate that there is no advantage over the use of a small volume in the hemorrhagic shock model in dogs. This might be due to increasing blood loss and dilution of the blood resulting in inability to meet oxygen delivery requirements.…”

Section: Discussionmentioning

confidence: 99%

Vasopressor Therapy Using Vasopressin Prior to Crystalloid Resuscitation in Irreversible Hemorrhagic Shock under Isoflurane Anesthesia in Dogs

Yoo

Kim

Eom

et al. 2007

The Journal of Veterinary Medical Science

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ABSTRACT. In the present study, we tested the hypothesis that vasopressin administration prior to crystalloid resuscitation can be used to improve hemodynamic and oxygen delivery functions. Hemorrhagic shock was experimentally induced by maintaining mean arterial pressure at 60 mmHg for 30 min in sixteen healthy dogs weighing from 8 to 10.6 kg. Vasopressin was administered and then volume resuscitation was performed for the 6 dogs of V-C group, while vasopressin was administered at the end of volume resuscitation in the 5 dogs of C-V group. The control group (n=5) was administered 0.4 IU/kg of vasopressin after induction of shock without fluid resuscitation. In all groups, hemodynamic parameters were measured pre-and post-hemorrhage and for 60 min after fluid resuscitation. The dogs in V-C group had substantially increased systolic arterial pressure (SAP) for 60 min and improved pulmonary capillary wedge pressure (PCWP), cardiac output (CO), oxygen delivery, and oxygen consumption indexes compared with C-V and control groups. Diastolic pressure and systemic vascular resistance was significantly lower in the V-C group than those in the C-V and control groups (P<0.05). In the V-C group, there was effective and rapid restoration of the SAP, CO, PCWP, and oxygen delivery parameters after treatment. This study indicates that vasopressin administration before crystalloid resuscitation is a more efficient way of improving hemodynamic and oxygen delivery functions in hemorrhagic shock in dogs.

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Section: Discussionmentioning

confidence: 99%

Vasopressor Therapy Using Vasopressin Prior to Crystalloid Resuscitation in Irreversible Hemorrhagic Shock under Isoflurane Anesthesia in Dogs

Yoo

Kim

Eom

et al. 2007

The Journal of Veterinary Medical Science

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“…Numerous studies since have confirmed the existence of this hemorrhage-induced shift of interstitial fluid into the vascular space that results from a fall in capillary hydrostatic pressure-a process now called transcapillary refill (32)(33)(34)(35). Transcapillary refill is transient however, lasting ∼1 h (32,35). It is limited by low interstitial compliance because, as fluid is reabsorbed from the interstitial space, interstitial fluid pressure falls.…”

Section: The Interstitiummentioning

confidence: 99%

A Modern View of the Interstitial Space in Health and Disease

Stewart

2020

Front. Vet. Sci.

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Increases in the volume of the interstitial space are readily recognized clinically as interstitial edema formation in the loose connective tissue of skin, mucosa, and lung. However, the contents and the hydrostatic pressure of this interstitial fluid can be very difficult to determine even in experimental settings. These difficulties have long obscured what we are beginning to appreciate is a dynamic milieu that is subject to both intrinsic and extrinsic regulation. This review examines current concepts regarding regulation of interstitial volume, pressure, and flow and utilizes that background to address three major topics of interest that impact IV fluid administration. The first of these started with the discovery that excess dietary salt can be stored non-osmotically in the interstitial space with minimal impact on vascular volume and pressures. This led to the hypothesis that, along with the kidney, the interstitial space plays an active role in the long-term regulation of blood pressure. Second, it now appears that hypovolemic shock leads to systemic inflammatory response syndrome principally through the entry of digestive enzymes into the intestinal interstitial space and the subsequent progression of enzymes and inflammatory agents through the mesenteric lymphatic system to the general circulation. Lastly, current evidence strongly supports the non-intuitive view that the primary factor leading to inflammatory edema formation is a decrease in interstitial hydrostatic pressure that dramatically increases microvascular filtration.

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“…Judicious use of adjunctive fluid products, including hypertonic saline and colloids, has been emphasized. A small percentage of crystalloid fluids have been shown to remain within the intravascular space and volumes may be even less in states of increased endothelial permeability . Hypertonic saline has been recommended and evaluated as it has been shown to alter hydraulic conductivity, decrease intestinal edema, and improve overall GI transit .…”

Section: Therapeutic Strategiesmentioning

confidence: 99%

Gastrointestinal dysmotility disorders in critically ill dogs and cats

Whitehead

Cortes

Eirmann

2016

J Vet Emergen Crit Care

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Objective -To review the human and veterinary literature regarding gastrointestinal (GI) dysmotility disorders in respect to pathogenesis, patient risk factors, and treatment options in critically ill dogs and cats. Etiology -GI dysmotility is a common sequela of critical illness in people and small animals. The most common GI motility disorders in critically ill people and small animals include esophageal dysmotility, delayed gastric emptying, functional intestinal obstruction (ie, ileus), and colonic motility abnormalities. Medical conditions associated with the highest risk of GI dysmotility include mechanical ventilation, sepsis, shock, trauma, systemic inflammatory response syndrome, and multiple organ failure. The incidence and pathophysiology of GI dysmotility in critically ill small animals is incompletely understood. Diagnosis -A presumptive diagnosis of GI dysmotility is often made in high-risk patient populations following detection of persistent regurgitation, vomiting, lack of tolerance of enteral nutrition, abdominal pain, and constipation. Definitive diagnosis is established via radioscintigraphy; however, this diagnostic tool is not readily available and is difficult to perform on small animals. Other diagnostic modalities that have been evaluated include abdominal ultrasonography, radiographic contrast, and tracer studies. Therapy -Therapy is centered at optimizing GI perfusion, enhancement of GI motility, and early enteral nutrition. Pharmacological interventions are instituted to promote gastric emptying and effective intestinal motility and prevention of complications. Promotility agents, including ranitidine/nizatidine, metoclopramide, erythromycin, and cisapride are the mainstays of therapy in small animals. Prognosis -The development of complications related to GI dysmotility (eg, gastroesophageal reflux and aspiration) have been associated with increased mortality risk. Institution of prophylaxic therapy is recommended in high-risk patients, however, no consensus exists regarding optimal timing of initiating prophylaxic measures, preference of treatment, or duration of therapy. The prognosis for affected small animal patients remains unknown. (J Vet Emerg

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Hematocrit and metabolic changes caused by varied resuscitation strategies in a canine model of hemorrhagic shock

Cited by 19 publications

References 30 publications

Vasopressor Therapy Using Vasopressin Prior to Crystalloid Resuscitation in Irreversible Hemorrhagic Shock under Isoflurane Anesthesia in Dogs

Vasopressor Therapy Using Vasopressin Prior to Crystalloid Resuscitation in Irreversible Hemorrhagic Shock under Isoflurane Anesthesia in Dogs

A Modern View of the Interstitial Space in Health and Disease

Gastrointestinal dysmotility disorders in critically ill dogs and cats

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