Effects of blood volume restitution following a portal hypertensive-related bleeding in anesthetized cirrhotic rats

被引:87
作者
Castañeda, B [1 ]
Morales, J [1 ]
Lionetti, R [1 ]
Moitinho, E [1 ]
Andreu, V [1 ]
Pérez-del-Pulgar, S [1 ]
Pizcueta, P [1 ]
Rodés, J [1 ]
Bosch, J [1 ]
机构
[1] Univ Barcelona, IDIBAPS, Hosp Clin, IMD,Liver Unit,Hepat Hemodynam Lab, E-08036 Barcelona, Spain
关键词
D O I
10.1053/jhep.2001.23437
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The aim of this study was to investigate the influence of different strategies of blood volume restitution in the outcome of portal hypertension-related bleeding in anesthetized cirrhotic rats. Gastrointestinal hemorrhage was induced by sectioning a first order branch of the ileocolic vein in 38 cirrhotic rats (common bile duct ligation and occlusion). The subsequent hypovolemic shock was treated with no transfusion (n = 17), moderate transfusion (50% of expected blood loss, 5 mL, n = 11), and total transfusion (100% of expected blood loss, 10 mL, n = 10), At the end of the blood transfusion period (minute 15), mean arterial pressure (MAP) partially recovered in rats receiving moderate transfusion or no transfusion but decreased in the 10-mL transfusion group (down arrow 12 +/- 43%, P < .05 vs. no transfusion and 5 mL transfusion). After transfusion, groups given no or 5 mL transfusion remained hemodynamically stable. However, rats receiving 10 mL transfusion continued to deteriorate with persistent bleeding and progressive fall in MAP (<down arrow> 65 +/- 12%; P < .05 vs. no transfusion and 5 mt transfusion), Collected blood loss was significantly greater in the 10-mL group (20.0 +/- 1.5 g) than in groups given 5 mL (15.9 +/- 2.8 g; P < .05) or no transfusion (13.2 +/- 2.1 g; P < .05 vs. 10 mL and 5 mL transfusion). Survival in the no transfusion group was 47%. Rats given 5-mL transfusion had 64% survival, The worst survival was observed in the 10-mL transfusion group (0% survival; P < .05), We concluded that a transfusion policy aimed at completely replacing blood loss worsens the magnitude of bleeding and mortality from portal hypertensive-related bleeding in cirrhotic rats. On the contrary, moderate blood transfusion allowed hemodynamic stabilization and increased survival.
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页码:821 / 825
页数:5
相关论文
共 29 条
[11]  
COLOMBATO LA, 1994, HEPATOLOGY, V20, pA100
[12]  
de Franchis R, 2000, J HEPATOL, V33, P846
[13]   EFFECTS OF KETAMINE, HALOTHANE, ENFLURANE, AND ISOFLURANE ON SYSTEMIC AND SPLANCHNIC HEMODYNAMICS IN NORMOVOLEMIC AND HYPOVOLEMIC CIRRHOTIC RATS [J].
DEBAENE, B ;
GOLDFARB, G ;
BRAILLON, A ;
JOLIS, P ;
LEBREC, D .
ANESTHESIOLOGY, 1990, 73 (01) :118-124
[14]   Effects of increasing blood hemoglobin levels on systemic hemodynamics of acutely anemic cirrhotic patients [J].
Elizalde, JI ;
Moitinho, E ;
García-Pagán, JC ;
Cirera, I ;
Escorsell, A ;
Bandi, JC ;
Jiménez, W ;
Bosch, J ;
Piqué, JM ;
Rodés, J .
JOURNAL OF HEPATOLOGY, 1998, 29 (05) :789-795
[15]   EFFECTS OF RITANSERIN, A SELECTIVE AND SPECIFIC S2-SEROTONERGIC ANTAGONIST, ON PORTAL PRESSURE AND SPLANCHNIC HEMODYNAMICS IN RATS WITH LONG-TERM BILE-DUCT LIGATION [J].
FERNANDEZ, M ;
PIZCUETA, P ;
GARCIAPAGAN, JC ;
FEU, F ;
CIRERA, I ;
BOSCH, J ;
RODES, J .
HEPATOLOGY, 1993, 18 (02) :389-393
[16]  
GARCIAPAGAN JC, 1994, HEPATOLOGY, V19, P1095, DOI 10.1002/hep.1840190506
[17]   A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care [J].
Hébert, PC ;
Wells, G ;
Blajchman, MA ;
Marshall, J ;
Martin, C ;
Pagliarello, G ;
Tweeddale, M ;
Schweitzer, I ;
Yetisir, E .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (06) :409-417
[18]   Acute hemodynamic changes following hemorrhage and volume restitution, using a low viscosity plasma expander, in anesthetized portal hypertensive rats [J].
Hilzenrat, N ;
Arish, A ;
Yaari, A ;
Sikuler, E .
JOURNAL OF HEPATOLOGY, 1999, 31 (05) :874-879
[19]   SYSTEMIC AND REGIONAL HEMODYNAMICS AFTER NITRIC-OXIDE SYNTHASE INHIBITION ROLE OF A NEUROGENIC MECHANISM [J].
HUANG, M ;
LEBLANC, ML ;
HESTER, RL .
AMERICAN JOURNAL OF PHYSIOLOGY, 1994, 267 (01) :R84-R88
[20]  
KESSLER RE, 1969, GASTROENTEROLOGY, V56, P538