Effects of Systemic Hypothermia on Microcirculation in Conditions of Hemodynamic Stability and in Hemorrhagic Shock.

Shock
Juan Francisco Caminos EguillorArnaldo Dubin

Abstract

Although hypothermia is independently associated with an increased mortality in trauma patients, it might be an effective therapeutic approach for otherwise lethal hemorrhage. The effect of hypothermia on microcirculation, however, has been poorly studied in this setting. Our goal was to characterize the effects of hypothermia on microcirculation in normal conditions and in severe hemorrhagic shock. In anesthetized and mechanically ventilated sheep, we measured cardiac output (CO), renal blood flow (RBF), and systemic and renal O2 consumption (VO2). Cortical renal, intestinal villi, and sublingual microcirculation was assessed by IDF-videomicroscopy. After basal measurements, sheep were assigned to hypothermia (n = 12) and normothermia (n = 12) groups. Central temperature was reduced to ∼34°C and maintained at baseline in each group, respectively. Measurements were repeated after 1 h of hemodynamic stable conditions and 1 h of severe hemorrhagic shock. In conditions of hemodynamic stability, the hypothermia group showed lower CO, RBF, and systemic and renal VO2 than the normothermia group. Red blood cell velocity was also lower in renal, villi, and sublingual microvascular beds (836 ± 195 vs. 1,066 ± 162, 916 ± 105 vs. 1051 ± 4...Continue Reading

References

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Mar 19, 2016·Journal of Applied Physiology·Gonzalo FerraraArnaldo Dubin
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Mar 23, 2017·The Journal of Trauma and Acute Care Surgery·Nathan J WhiteAndrew P Cap
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Jul 12, 2019·Journal of Applied Physiology·Gonzalo FerraraArnaldo Dubin
Sep 3, 2019·The Journal of International Medical Research·Thomas Kander, Ulf Schött

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Citations

Jan 8, 2021·Vascular Health and Risk Management·Arnaldo DubinGonzalo Ferrara
May 18, 2021·Intensive Care Medicine Experimental·Anoek L I van LeeuwenCharissa E van den Brom

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