Post-occlusive reactive hyperemia variables can be used to diagnose vascular dysfunction in hemorrhagic shock

IF 2.9 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Aleksey Dubensky, Ivan Ryzhkov, Zoya Tsokolaeva, Konstantin Lapin, Sergey Kalabushev, Lidia Varnakova, Vladimir Dolgikh
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Abstract

Introduction

Laser doppler flowmetry (LDF) allows non-invasive assessment of microvascular functions. The combination of LDF with an occlusion functional test enables study of post-occlusive reactive hyperemia (PORH), providing additional information about vasomotor function, capillary blood flow reserve, and the overall reactivity of the microvascular system.

Aim

To identify early alterations of PORH variables in the skin of a rat in hemorrhagic shock (HS).

Material and methods

Male Wistar rats (n = 14) weighing 400–450 g were anesthetized with a combination of tiletamine/zolazepam (20 mg/kg) and xylazine (5 mg/kg). The animals breathed on their own, and were placed on a heated platform in the supine position. A PE-50 catheter was inserted into the carotid artery to measure the mean arterial pressure (MAP). The optical probe of the Laser Doppler device was installed on the plantar surface of the hind limb of a rat; a pneumatic cuff was applied proximal to the same limb. The occlusion time was 3 min. The following physiological variables were measured at baseline and 30 min after blood loss: MAP, mmHg; mean cutaneous blood flow (M, PU); cutaneous vascular conductance (CVC = M/MAP); peak hyperemia (Mmax, PU) and maximum cutaneous vascular conductance (CVCmax) during PORH. In the HS group (n = 7), 30 % of the estimated blood volume was taken within 5 min. There was no blood loss in the group of sham-operated animals (Sham, n = 7). The results are presented as Me [25 %;75 %]. The U-Mann-Whitney criterion was used to evaluate intergroup differences. Differences were considered statistically significant at p < 0.05.

Results

The groups did not differ at baseline. Blood loss led to a significant decrease in MAP (43 [31;46] vs. 94 [84;104] mmHg), M (11.5 [16.9;7.8] vs 16.7 [20.2;13.9]) and Mmax (18.1 [16.4;21.8] vs. 25.0 [23.0;26.2]) in the HS group compared to the Sham group, respectively. At the same time, both CVC (0.25 [0.23;0.30] vs. 0.16 [0.14;0.21]) and CVCmax (0.55 [0.38;0.49] vs 0.24 [0.23; 0.29]) increased after blood loss in the HS group compared to the Sham group. Arterial blood gas analysis revealed metabolic lactic acidosis in the HS group.

Conclusion

In this rat model of HS, alterations in cutaneous blood flow are manifested by a decrease in perfusion (M) and the intensity of PORH (Mmax) with a simultaneous increase in vascular conductance (CVC and CVCmax).

闭塞后反应性充血变量可用于诊断失血性休克的血管功能障碍
导言激光多普勒血流测量仪(LDF)可对微血管功能进行无创评估。激光多普勒血流测量仪与闭塞功能测试相结合,可对闭塞后反应性充血(PORH)进行研究,提供有关血管运动功能、毛细血管血流储备和微血管系统整体反应性的更多信息。材料和方法体重 400-450 克的雄性 Wistar 大鼠(n = 14)用瓦他敏/唑拉西泮(20 毫克/千克)和异丙嗪(5 毫克/千克)联合麻醉。动物自主呼吸,并以仰卧姿势放在加热平台上。将 PE-50 导管插入颈动脉,测量平均动脉压(MAP)。激光多普勒装置的光学探头安装在一只大鼠后肢的足底表面;气动袖带安装在同一肢体的近端。闭塞时间为 3 分钟。在基线和失血后 30 分钟测量了以下生理变量:MAP,mmHg;平均皮肤血流量(M,PU);皮肤血管传导(CVC = M/MAP);PORH 期间的峰值充血(Mmax,PU)和最大皮肤血管传导(CVCmax)。在 HS 组(n = 7)中,30% 的估计血量是在 5 分钟内抽取的。假手术动物组(Sham,n = 7)没有失血。结果以 Me [25 %;75 %] 表示。采用 U-Mann-Whitney 标准评估组间差异。结果各组在基线时无差异。与 Sham 组相比,失血导致 HS 组的 MAP(43 [31;46] vs. 94 [84;104] mmHg)、M(11.5 [16.9;7.8] vs. 16.7 [20.2;13.9] )和 Mmax(18.1 [16.4;21.8] vs. 25.0 [23.0;26.2] )分别显著下降。同时,与 Sham 组相比,HS 组失血后的 CVC(0.25 [0.23;0.30] vs. 0.16 [0.14;0.21] )和 CVCmax(0.55 [0.38;0.49] vs 0.24 [0.23; 0.29])均有所增加。结论在这种 HS 大鼠模型中,皮肤血流的改变表现为灌注量(M)和 PORH 强度(Mmax)的降低,同时血管传导(CVC 和 CVCmax)的增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Microvascular research
Microvascular research 医学-外周血管病
CiteScore
6.00
自引率
3.20%
发文量
158
审稿时长
43 days
期刊介绍: Microvascular Research is dedicated to the dissemination of fundamental information related to the microvascular field. Full-length articles presenting the results of original research and brief communications are featured. Research Areas include: • Angiogenesis • Biochemistry • Bioengineering • Biomathematics • Biophysics • Cancer • Circulatory homeostasis • Comparative physiology • Drug delivery • Neuropharmacology • Microvascular pathology • Rheology • Tissue Engineering.
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