Renal Effects of Hemorrhage in Normal Man

Stone, Alex; Stahl, William M.

doi:10.1097/00000658-197011000-00007

Cited by 32 publications

(11 citation statements)

References 6 publications

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“…As during bleeding, FBF did not change significantly during the post-haemorrhage period, or during retransfusion, but this parameter was quite variable between animals (Fig. 2) (Sondeen, Gonzaludo, Loveday, Deshon, Clifford, Hunt, Rodkey & Wade, 1990) and humans (Stone & Stahl, 1970).…”

Section: Haemorrhage Periodmentioning

confidence: 87%

Haemodynamic responses to hypotensive haemorrhage in conscious sheep with emphasis on renal and femoral blood flow

Gunnarsson¹,

Hjelmqvist²,

Rundgren³

1994

Experimental Physiology

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SUMMARYHaemodynamic responses to slow (0 7 ml kg-1 min-') haemorrhage were investigated in eight adult conscious sheep, fitted with permanent ultrasonic flow probes around the renal and femoral artery. The haemorrhage was continued until the mean systemic arterial pressure (MSAP) suddenly dropped to about 50 mmHg. The spontaneous recovery was followed for 60 min and then the blood was retransfused. A distinct fall in MSAP was obtained after 14-5 + 09 ml blood (kg body weight)-' (24% of the estimated blood volume) had been removed, but the interindividual differences were rather large (range, 102-18-1 ml kg-1).Therefore, the haemodynamic responses during haemorrhage were related to the total bleeding volume and not to time or volume per kilogram body weight. Before 90% of the total haemorrhage volume had been removed, the MSAP decreased gradually, reaching statistical significance at 80 % (P < 0 05). At end of bleeding the cardiac output (CO) had fallen from a pre-haemorrhage level of 4 7 + 0-2 to 2 9 + 0-2 1 min-'. Although the femoral blood flow (FBF) was largely unaffected by the haemorrhage, and thus increased as a fraction of CO, the total systemic vascular resistance was markedly increased during the post-haemorrhage period, indicating a longer lasting elevation of vascular resistance in other vascular beds. In spite of a concomitant marginal decrease in renal blood flow (RBF), the renal vascular resistance (RVR) was unchanged until 90 % total haemorrhage had occurred. At the same time as blood pressure fell, RBF decreased markedly, concomitant with a transient increase in RVR, which was followed by a decrease towards basal levels. As a result, the RBF as a percentage of CO decreased, indicating a significant redistribution of blood away from the kidneys; this lasted for about 15 min after the end of haemorrhage. While MSAP, central venous pressure and FBF were elevated above basal levels by the retransfusion, RBF was not fully restored. The results show that RBF is preserved during haemorrhage in conscious sheep, until marked systemic hypotension ensues. The redistribution of blood away from the kidneys appears rather transient after an acute hypotensive haemorrhage in this species; this is also true for the blood flow to the hindlimb, which was little affected by the blood loss.

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Section: Haemorrhage Periodmentioning

confidence: 87%

Haemodynamic responses to hypotensive haemorrhage in conscious sheep with emphasis on renal and femoral blood flow

Gunnarsson¹,

Hjelmqvist²,

Rundgren³

1994

Experimental Physiology

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“…More than 30 years ago, Stone & Stahl (1970) examined the renal effects of haemorrhage of ~20 % of vascular volume in normal human subjects, and reported a ~25 % decrease in RBF and GFR. In a more recent study in conscious pigs by Sondeen et al (1990), 20 % haemorrhage was reported to be associated with a ~30 % decrease in RBF whereas GFR remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

Renal Sympathetic Nerves do not Modulate Renal Responses to Haemorrhage in Conscious Lambs

Smith

2002

Experimental Physiology

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The present study was designed to investigate the renal responses to hypotensive haemorrhage early in life and the role of renal sympathetic nerves in modulating these renal responses. To this end, experiments were carried out in conscious, chronically instrumented lambs with either intact renal nerves (n = 7, Intact) or bilateral renal denervation performed at the time of surgery (n = 5, Denervated). Parameters of renal function were measured before and after 20% haemorrhage (experiment 1) and 0% haemorrhage (experiment 2), the latter serving as a time control. The two experiments were performed in random order at intervals of 24‐48 h. Within 20 min of hypotensive haemorrhage in intact lambs, glomerular filtration rate decreased by ∼60%; this response was not altered by renal denervation. Since renal plasma flow remained constant after haemorrhage, the filtration fraction also decreased. After 20% haemorrhage, urinary flow rate decreased in intact lambs; this response was also not altered by renal denervation. Excretion rates of Na+ and K+ as well as urinary osmolality and free water clearance were not altered by haemorrhage in either intact or denervated lambs. These data provide the first description of renal responses to haemorrhage early in life. In addition, the present findings provide new information that renal responses to haemorrhage early in life do not appear to be modulated by renal sympathetic nerves.

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“…A small inflatable cuft is placed around the renal artery to produce incre mental falls in renal artery pressure, with the simultaneous measurement of renal artery pres sure and flow. Stone and Stahl [12] studied the renal effects of haemorrhage in normal humans, and concluded that a decrease in mean perfusion pressure from 80 to 62 mm Hg reduced the RBF by approximately 30%, thus implying a similar threshold value. This value is likely to change under different circumstances.…”

Section: Norm Al Autoregulationmentioning

confidence: 99%