An Ovine Model of Hemorrhagic Shock and Resuscitation, to Assess Recovery of Tissue Oxygen Delivery and Oxygen Debt, and Inform Patient Blood Management
Autor: | Gianluigi Li Bassi, Sacha Rozencwajg, Fergal T. Temple, Gabriela Simonova, J. Jung, Sara Chiaretti, Chiara Palmieri, Karin Wildi, Wayne B. Dyer, David O. Irving, S. Colombo, John-Paul Tung, T. Shuker, Aryeh Shander, John F. Fraser, C. Ainola, Jacky Y. Suen |
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Rok vydání: | 2021 |
Předmět: |
Resuscitation
Blood management Blood volume Shock Hemorrhagic Critical Care and Intensive Care Medicine Oxygen Consumption Animals Humans Medicine Blood Transfusion Sheep business.industry 1103 Clinical Sciences Recovery of Function Venous blood Middle Aged Emergency & Critical Care Medicine Oxygen tension Oxygen Disease Models Animal Shock (circulatory) Anesthesia Emergency Medicine Female Base excess Hemoglobin medicine.symptom business |
Zdroj: | Shock. 56:1080-1091 |
ISSN: | 1540-0514 1073-2322 |
Popis: | BACKGROUND: Aggressive fluid or blood component transfusion for severe hemorrhagic shock may restore macrocirculatory parameters, but not always improve microcirculatory perfusion and tissue oxygen delivery. We established an ovine model of hemorrhagic shock to systematically assess tissue oxygen delivery and repayment of oxygen debt; appropriate outcomes to guide Patient Blood Management. METHODS: Female Dorset-cross sheep were anesthetized, intubated, and subjected to comprehensive macrohemodynamic, regional tissue oxygen saturation (StO2), sublingual capillary imaging, and arterial lactate monitoring confirmed by invasive organ-specific microvascular perfusion, oxygen pressure, and lactate/pyruvate levels in brain, kidney, liver, and skeletal muscle. Shock was induced by stepwise withdrawal of venous blood until MAP was 30 mm Hg, mixed venous oxygen saturation (SvO2) 4 mM. Resuscitation with PlasmaLyte® was dosed to achieve MAP > 65 mm Hg. RESULTS: Hemorrhage impacted primary outcomes between baseline and development of shock: MAP 89 ± 5 to 31 ± 5 mm Hg (P |
Databáze: | OpenAIRE |
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