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Department of Pediatrics, Women and Infants' Hospital of Rhode Island, Brown University School of Medicine, Providence, Rhode Island 02905
We studied the effects of hypoxia on cerebral cortical
and intestinal perfusion and metabolism in normocythemic hyperviscous newborn pigs. Seven pigs were made hyperviscous by an
injection of cryoprecipitate, increasing viscosity from 5.8 ± 0.9 to
9.0 ± 1.2 (SD) cycles/s. Six normoviscous pigs received
0.9% NaCl. Reducing the inspired O2 decreased the arterial
O2 content (CaO2) from 9.5 ± 1.6 to 3.6 ± 1.3 ml O2/100 ml. Increases
in brain and decreases in gastrointestinal blood flow at the lower
CaO2 values were similar between the
groups. During hypoxia, blood flow to stomach, distal intestinal
mucosa, and large intestines was lower (
50,
23, and
28%, respectively) in the hyperviscous than normoviscous group.
At the lower CaO2 values, cerebral
cortical vascular resistance decreased in both groups and intestinal
vascular resistance increased (+257%) in the hyperviscous but not in
the normoviscous group. During hypoxia, systemic oxygen delivery
decreased, extraction increased, and uptake did not change; cerebral
cortical O2 delivery, extraction, and uptake did not
change; and intestinal O2 delivery decreased, extraction
increased, and uptake did not change in both groups. Our study
demonstrated that 1) during hypoxia, increases in systemic
O2 extraction compensated for decreases in delivery and
systemic uptake did not change; vasodilation sustained cerebral cortical O2 delivery and preserved metabolism; increases in
intestinal oxygen extraction offset decreases in delivery and uptake
was preserved; and 2) nonpolycythemic hyperviscosity did not
have a major influence on cardiovascular or metabolic responses to hypoxia, except for modest effects on intestinal resistance and perfusion to certain gastrointestinal regions. We conclude that, under
normocythemic conditions, a moderate increase in viscosity does not
have a major impact on hemodynamic or metabolic adjustments to hypoxia
in newborn pigs.
brain; gastrointestinal tract; hyperviscosity; polycythemia; metabolism; hemodynamic response
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