Krejci, V.; Hiltebrand, L.; Banic, A.; Erni, D.; Wheatley, A. M.; Sigurdsson, G. H. (2000). Continuous measurements of microcirculatory blood flow in gastrointestinal organs during acute haemorrhage. British journal of anaesthesia, 84(4), pp. 468-475. Oxford University Press 10.1093/oxfordjournals.bja.a013472
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Hypoperfusion of splanchnic organs is an important contributor to the development of multiple organ failure after major surgery and trauma. During general anaesthesia and surgery we compared changes in systemic haemodynamics and regional blood flow with changes in the distribution of microcirculatory flow (MBF) in multiple splanchnic organs in pigs exposed to acute haemorrhage. Seven pigs (25 kg) were bled to a mean arterial pressure of 40 mm Hg; 180 min later the shed blood was retransfused. MBF was measured in the intestinal mucosa (stomach, jejunum, colon), pancreas, liver and kidney using a six-channel laser Doppler flowmeter. Cardiac output was measured by thermodilution and superior mesenteric artery flow by ultrasonic flowmetry. During haemorrhage, MBF in the gastric and colon mucosa and flow in the liver and kidney decreased to a similar extent to regional and systemic flows (30-50%). In contrast, MBF in the jejunal mucosa remained virtually unchanged and flow in the pancreas decreased significantly more than systemic and regional flows (60%, P < 0.05). We conclude that: (1) changes in the distribution of MBF in the gastrointestinal tract during acute haemorrhage are heterogeneous and cannot be predicted from changes in systemic or regional haemodynamics; (2) MBF in the jejunal mucosa did not decrease during haemorrhage, indicating that autoregulation of blood flow in the mucosa remained intact during shock; and (3) MBF in the pancreas decreased significantly more than systemic and regional flows during shock, suggesting that the pancreas is particularly vulnerable to haemorrhage.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery |
UniBE Contributor: |
Krejci, Vladimir, Hiltebrand, Luzius, Banic, Andrej, Erni, Dominique |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0007-0912 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Marceline Brodmann |
Date Deposited: |
30 Sep 2020 16:21 |
Last Modified: |
05 Dec 2022 15:13 |
Publisher DOI: |
10.1093/oxfordjournals.bja.a013472 |
BORIS DOI: |
10.7892/boris.115867 |
URI: |
https://boris.unibe.ch/id/eprint/115867 |
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