Intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage
The alterations in O₂ extraction in hemodilution have been linked to fast red blood cell (RBC) velocity, which might affect the complete release of O₂ from Hb. Fast RBC velocity might also explain the normal mucosal-arterial Pco2 (ΔPco₂). Yet sublingual and intestinal microcirculation have not been...
| Autores principales: | , , , , , , , , , |
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| Formato: | Articulo |
| Lenguaje: | Inglés |
| Publicado: |
2016
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| Acceso en línea: | http://sedici.unlp.edu.ar/handle/10915/130425 |
| Aporte de: |
| id |
I19-R120-10915-130425 |
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| record_format |
dspace |
| institution |
Universidad Nacional de La Plata |
| institution_str |
I-19 |
| repository_str |
R-120 |
| collection |
SEDICI (UNLP) |
| language |
Inglés |
| topic |
Medicina microcirculation PCO2 hypoxia Anemia hemorrhage |
| spellingShingle |
Medicina microcirculation PCO2 hypoxia Anemia hemorrhage Ferrara, Gonzalo Kanoore Edul, Vanina Siham Martins, Enrique Francisco Canales, Héctor Saúl Canullán, Carlos Murias, Gastón Pozo, Mario Omar Estenssoro, Elisa Ince, Can Dubin, Arnaldo Intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage |
| topic_facet |
Medicina microcirculation PCO2 hypoxia Anemia hemorrhage |
| description |
The alterations in O₂ extraction in hemodilution have been linked to fast red blood cell (RBC) velocity, which might affect the complete release of O₂ from Hb. Fast RBC velocity might also explain the normal mucosal-arterial Pco2 (ΔPco₂). Yet sublingual and intestinal microcirculation have not been completely characterized in extreme hemodilution. Our hypothesis was that the unchanged ΔPco₂ in hemodilution depends on the preservation of villi microcirculation. For this purpose, pentobarbital-anesthetized and mechanically ventilated sheep were submitted to stepwise hemodilution (n = 8), hemorrhage (n = 8), or no intervention (sham, n = 8). In both hypoxic groups, equivalent reductions in O₂ consumption (Vo₂) were targeted. Microcirculation was assessed by videomicroscopy, intestinal ΔPco₂ by air tonometry, and Vo₂ by expired gases analysis. Although cardiac output and superior mesenteric flow increased in hemodilution, from the very first step (Hb = 5.0 g/dl), villi functional vascular density and RBC velocity decreased (21.7 ± 0.9 vs. 15.9 ± 1.0 mm/mm² and 1,033 ± 75 vs. 850 ± 79 μm/s, P < 0.01). In the last stage (Hb = 1.2 g/dl), these variables were lower in hemodiution than in hemorrhage (11.1 ± 0.5 vs. 15.4 ± 0.9 mm/mm² and 544 ± 26 vs. 686 ± 70 μm/s, P < 0.01), and were associated with lower intestinal fractional O₂ extraction (0.61 ± 0.04 vs. 0.79 ± 0.02, P < 0.01) but preserved ΔPco₂ (5 ± 2 vs. 25 ± 4 mmHg, P < 0.01). Therefore, alterations in O₂ extraction in hemodilution seemed related to microvascular shunting, not to fast RBC velocity. The severe microvascular abnormalities suggest that normal ΔPco₂ was not dependent on CO₂ washout by the villi microcirculation. Increased perfusion in deeper intestinal layers might be an alternative explanation. |
| format |
Articulo Articulo |
| author |
Ferrara, Gonzalo Kanoore Edul, Vanina Siham Martins, Enrique Francisco Canales, Héctor Saúl Canullán, Carlos Murias, Gastón Pozo, Mario Omar Estenssoro, Elisa Ince, Can Dubin, Arnaldo |
| author_facet |
Ferrara, Gonzalo Kanoore Edul, Vanina Siham Martins, Enrique Francisco Canales, Héctor Saúl Canullán, Carlos Murias, Gastón Pozo, Mario Omar Estenssoro, Elisa Ince, Can Dubin, Arnaldo |
| author_sort |
Ferrara, Gonzalo |
| title |
Intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage |
| title_short |
Intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage |
| title_full |
Intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage |
| title_fullStr |
Intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage |
| title_full_unstemmed |
Intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage |
| title_sort |
intestinal and sublingual microcirculation are more severely compromised in hemodilution than in hemorrhage |
| publishDate |
2016 |
| url |
http://sedici.unlp.edu.ar/handle/10915/130425 |
| work_keys_str_mv |
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Repositorios |
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