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J Appl Physiol 83: 1832-1841, 1997;
8750-7587/97 $5.00
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Vol. 83, Issue 6, 1832-1841, December 1997

Myocardial blood flow heterogeneity in shock and small-volume resuscitation in pigs with coronary stenosis

Martin Kleen1,2, Martin Welte1,2, Peter Lackermeier1,2, Oliver Habler1,2, Gregor Kemming2, and Konrad Messmer1

1 Institute for Surgical Research and 2 Institute of Anesthesiology, University of Munich, 81366 Munich, Germany

Received 24 March 1997; accepted in final form 25 July 1997.

Kleen, Martin, Martin Welte, Peter Lackermeier, Oliver Habler, Gregor Kemming, and Konrad Messmer. Myocardial blood flow heterogeneity in shock and small-volume resuscitation in pigs with coronary stenosis. J. Appl. Physiol. 83(6): 1832-1841, 1997.---We analyzed the effects of shock and small-volume resuscitation in the presence of coronary stenosis on fractal dimension (D) and spatial correlation (SC) of regional myocardial perfusion. Hemorrhagic shock was induced and maintained for 1 h. Pigs were resuscitated with hypertonic saline-dextran 60 [HSDex, 10% of shed blood volume (SBV)] or normal saline (NS; 80% of SBV). Therapy was continued after 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 coronary artery stenosis changed neither D nor SC. 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 decreased D to 1.22 ± 0.05, whereas NS did not change D. SC was increased by both HSDex (0.56 ± 0.1) and NS (0.53 ± 0.06). At 1 h after resuscitation, SC was constant in both groups, and D was reduced only in the NS group (1.18 ± 0.02). We conclude that hemorrhagic shock homogenized regional myocardial perfusion in coronary stenosis and that fluid therapy failed to restore this.

fractals; spatial heterogeneity; regional perfusion; hypertonic saline; dextran

0161-7567/97 $5.00 Copyright © 1997 the American Physiological Society




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