| Abstract: | Kleen, Martin, Martin Welte, Peter Lackermeier, OliverHabler, Gregor Kemming, and Konrad Messmer. Myocardial blood flowheterogeneity in shock and small-volume resuscitation in pigs withcoronary stenosis. J. Appl. Physiol.83(6): 1832-1841, 1997. We analyzed the effects of shock andsmall-volume resuscitation in the presence of coronary stenosis onfractal dimension (D) and spatialcorrelation (SC) of regional myocardial perfusion. Hemorrhagic shockwas induced and maintained for 1 h. Pigs were resuscitated withhypertonic saline-dextran 60 HSDex, 10% of shed blood volume(SBV)] or normal saline (NS; 80% of SBV). Therapy was continuedafter 30 min with dextran (10% SBV). At baseline, D was 1.39 ± 0.06 (mean ± SE;HSDex group) and 1.34 ± 0.04 (NS group). SC was 0.26 ± 0.07 (HSDex) and 0.26 ± 0.04 (NS). Left anterior descending coronaryartery stenosis changed neither D norSC. Shock significantly reduced D(i.e., homogenized perfusion): 1.26 ± 0.06 (HSDex) and 1.23 ± 0.05 (NS). SC was increased: 0.41 ± 0.1 (HSDex) and 0.48 ± 0.07 (NS). Fluid therapy with HSDex further decreasedD to 1.22 ± 0.05, whereas NS didnot change D. SC was increased by bothHSDex (0.56 ± 0.1) and NS (0.53 ± 0.06). At 1 h afterresuscitation, SC was constant in both groups, andD was reduced only in the NS group(1.18 ± 0.02). We conclude that hemorrhagic shock homogenizedregional myocardial perfusion in coronary stenosis and that fluidtherapy failed to restore this. |
