Low-Dose Ethanol Alters the Cardiovascular, Metabolic, and Respiratory Compensation for Severe Blood Loss

McDonough, Kathleen H.; Giaimo, Mary E.; Miller, Heather G.; Gentilello, Larry M.

doi:10.1097/00005373-200209000-00024

Cited by 35 publications

(24 citation statements)

References 12 publications

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“…Altogether, these studies suggested that the alteration in cardiac function is influenced by many factors including the surface burn area. With regard to alcohol intoxication, studies have shown that both acute and chronic alcohol ingestion result in altered hemodynamic responses (9,11,12,22,28). We observed that 24 h after the ingestion of alcohol, there was an increase in blood flow and DO 2 to the intestine and liver in the absence of injury.…”

Section: Discussionmentioning

confidence: 63%

“…However, if the mild injury is superimposed with additional stress factors, it produces alterations in cardiac functions and organ blood flow similar to those observed in experimental models of severe injury (31). McDonough et al (22) have shown that in conscious guinea pigs, intraperitoneal administration of a moderate dose of alcohol before trauma potentiates cardiac dysfunction and decreases the mean time to death. Phelan et al (28) showed that alcohol intoxication blunted counterregulatory responses to blood loss.…”

Section: Discussionmentioning

confidence: 82%

“…We observed that 24 h after the ingestion of alcohol, there was an increase in blood flow and DO 2 to the intestine and liver in the absence of injury. Although many of the previous studies have shown that acute alcohol ingestion results in impaired heart functions, some have suggested that acute alcohol ingestion improves cardiac function (9,11,12,22). The contradictory reports of acute alcohol-induced cardiovascular changes are likely due to the differences in animals models, routes of alcohol administration (intraperitoneal vs. intragastric), the amount of alcohol consumed, and the time at which the studies were performed after alcohol intoxication.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that hepatocellular, intestinal, and renal dysfunctions occur early after burn, trauma, and hemorrhagic shock and that these dysfunctions are associated with tissue hypoperfusion (1,16,20,30,33,34). Similarly, alcohol ingestion has also been shown to influence hemodynamic responses (9,11,12,22,28). However, no study to date has evaluated the hemodynamic response to a combined insult of alcohol and burn injury.…”

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confidence: 99%

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Alcohol ingestion before burn injury decreases splanchnic blood flow and oxygen delivery

Choudhry¹,

Ba²,

Rana³

et al. 2005

American Journal of Physiology-Heart and Circulatory Physiology

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. Alcohol ingestion before burn injury decreases splanchnic blood flow and oxygen delivery. Am J Physiol Heart Circ Physiol 288: H716 -H721, 2005. First published September 23, 2004; doi:10.1152/ajpheart.00797.2004.-Recent studies from our laboratory have shown that alcohol and burn injury impair intestinal barrier and immune functions. Although multiple factors can contribute to impaired intestinal barrier function, such an alteration could result from a decrease in intestinal blood flow (BF) and oxygen delivery (DO2). Therefore, in this study, we tested the hypothesis that alcohol ingestion before burn injury reduces splanchnic blood flow and oxygen delivery. Rats (250 g) were gavaged with alcohol to achieve a blood ethanol level in the range of 100 mg/dl before burn or sham injury (25% total body surface area). Day 1 after injury, animals were anesthetized with methoxyflurane. Blood pressure, cardiac output (CO), ϮdP/dt, organ BF (in ml ⅐ min Ϫ1 ⅐ 100 g Ϫ1 ), and DO2 (in mg ⅐ ml Ϫ1 ⅐ 100 g Ϫ1 ) were determined. CO and organ BF were determined using a radioactive microsphere technique. Our results indicate that blood pressure, CO, and ϩdP/dt were decreased in rats receiving a combined insult of alcohol and burn injury compared with rats receiving either burn injury or alcohol alone. This is accompanied by a decrease in BF and DO 2 to the liver and intestine. No significant change in BF to the coronary arteries (heart), brain, lung, skin, and muscles was observed after alcohol and burn injury. In conclusion, the results presented here suggest that alcohol ingestion before burn injury reduces splanchnic BF and DO 2. Such decreases in BF and DO2 may cause hypoxic insult to the intestine and liver. Although a hypoxic insult to the liver would result in a release of proinflammatory mediators, a similar insult to the intestine will likely perturb both intestinal immune cell and barrier functions, as observed in our previous study. hemodynamic; liver; intestine; shock; trauma; ethanol; cardiovascular response; thermal injury NEARLY 50% of burn and a similar percentage of trauma patients are found positive for alcohol at the time of hospital admission (6,21,25). Previous studies have suggested that the severity of injury is increased in patients who have consumed alcohol before injury compared with those who have not (for reviews, see Refs. 6,21,and 25). These studies have shown that intoxicated patients require frequent intubations, experience delayed wound healing, and unnecessary longer hospital stays (6,7,11,18,21,(23)(24)(25). As a consequence, enormous resources are consumed to treat trauma patients who are positive for blood alcohol compared with those who sustained injuries in the absence of alcohol. Furthermore, intoxicated patients are more susceptible to infection and are more likely to die than injured patients who are not intoxicated at the time of injury (6,18,21,(23)(24)(25). In contrast, some studies suggest that alcohol does not influence the severity of injury (7, 11), whereas others have suggested t...

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Alcohol ingestion before burn injury decreases splanchnic blood flow and oxygen delivery

Choudhry¹,

Ba²,

Rana³

et al. 2005

American Journal of Physiology-Heart and Circulatory Physiology

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show abstract

“…Ethanol is demonstrated to have many adverse effects on the CNS by depression of hemodynamic and respiratory centers; decrease in regional cerebral blood flow 16 and resulting cerebral ischemia; formation of free radicals; dysfunction of Na ϩ / K ϩ -ATPase; and disruption of ionic homeostasis, such as effects on ion influx, including Na ϩ , Ca 2ϩ , and Mg ϩϩ .…”

Section: Discussionmentioning

confidence: 99%