Effects of simulated hypovolaemia on haemodynamics, left ventricular function, mesenteric blood flow and gastric Pco2.

Details

Serval ID
serval:BIB_8F2CD9B0D026
Type
Article: article from journal or magazin.
Collection
Publications
Title
Effects of simulated hypovolaemia on haemodynamics, left ventricular function, mesenteric blood flow and gastric Pco2.
Journal
Acta Anaesthesiologica Scandinavica
Author(s)
Steiner L.A., Staender S., Sieber C.C., Skarvan K.
ISSN
0001-5172
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
51
Number
2
Pages
143-150
Language
english
Abstract
BACKGROUND: Compensated clinically silent hypovolaemia may lead to low cardiac output, hypoperfusion and ischaemia. We investigated the cardiovascular effects of simulated hypovolaemia to determine whether it caused mesenteric ischaemia detectable by gastric tonometry. METHODS: Thirteen healthy volunteers, aged 21-36 years, were investigated. Lower body negative pressure (LBNP) was used to simulate normotensive hypovolaemia. Cardiovascular parameters were measured using echocardiography. Mesenteric blood flow was investigated using Doppler sonography of the superior mesenteric artery (SMA). Gastric Pco(2) (P(g)co(2)) was measured using gas tonometry. Data were collected at baseline, LBNP and during a recovery period. RESULTS: Normotensive hypovolaemia was induced successfully in 11 volunteers. There were no significant differences in mean arterial pressure between the three data points (91 +/- 6, 93 +/- 10 and 95 +/- 9 mmHg, respectively). With the induction of LBNP, the heart rate increased from 64 +/- 16 to 73 +/- 16 beats/min (P < 0.001), the cardiac index decreased from 2.7 +/- 1.0 to 1.8 +/- 0.6 l/min/m(2) (P= 0.002) and the systemic vascular resistance increased from 1535 +/- 445 to 2270 +/- 550 dyn s/cm(5) (P < 0.001). The SMA mean flow velocity decreased from 53 +/- 18 to 37 +/- 20 cm/s (69 +/- 20%) (P= 0.007), and increased to 56 +/- 34 cm/s (106 +/- 38%) (P= 0.001) during reperfusion. The SMA resistance increased from 92 +/- 30 to 174 +/- 110 mmHg/l/min (P= 0.004). These changes were reversible after termination of LBNP. By contrast, there were no significant differences in P(g)co(2) between the three data points. CONCLUSIONS: In these volunteers, the mesenteric vascular bed contributed importantly to the maintenance of arterial pressure during normotensive hypovolaemia. However, this compensated hypovolaemia did not compromise the mesenteric perfusion sufficiently to increase P(g)co(2) and to allow detection by tonometry.
Keywords
Adult, Analysis of Variance, Blood Volume/physiology, Carbon Dioxide/analysis, Carbon Dioxide/metabolism, Cardiac Output/physiology, Echocardiography, Heart Rate/physiology, Humans, Hypovolemia/diagnosis, Hypovolemia/etiology, Lower Body Negative Pressure, Male, Manometry/methods, Mesenteric Artery, Superior/physiology, Observer Variation, Regional Blood Flow/physiology, Stomach/metabolism, Ultrasonography, Doppler, Duplex, Vascular Resistance/physiology, Ventricular Function, Left/physiology
Pubmed
Web of science
Create date
10/12/2009 16:39
Last modification date
03/03/2018 19:21
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