Noradrenaline inhibits vasoconstriction induced by electrical stimulation

Vasoconstriction by electrical stimulation: new approach to control of non-compressible hemorrhage

Non-compressible hemorrhage is the most common preventable cause of death on battlefield and in civilian traumatic injuries. We report the use of microsecond pulses of electric current to induce rapid constriction in femoral and mesenteric arteries and veins in rats. Electrically-induced vasoconstriction could be induced in seconds while blood vessels dilated back to their original size within minutes after stimulation. At higher settings, a blood clotting formed, leading to complete and permanent occlusion of the vessels. The latter regime dramatically decreased the bleeding rate in the injured femoral and mesenteric arteries, with a complete hemorrhage arrest achieved within seconds. The average blood loss from the treated femoral artery during the first minute after injury was about 7 times less than that of a non-treated control. This new treatment modality offers a promising approach to non-damaging control of bleeding during surgery, and to efficient hemorrhage arrest in trauma patients.

Miniature electrical stimulator for hemorrhage control

Noncompressible hemorrhage is currently the most common cause of preventable death in battlefield and in civilian trauma injuries. Tourniquets, specialized wound dressings, and hemorrhage-inhibiting biomaterials are not sufficiently effective in arrest of noncompressible hemorrhage and often cause collateral tissue damage. An effective, easy-to-use, portable device is needed to reduce blood loss in trauma patients immediately following injury and to maintain hemorrhage control up to several hours-until the injured is evacuated to a medical facility. We developed a miniature electrical stimulator to induce vascular constriction and, thereby, reduce hemorrhage. Vasoconstriction of the rat femoral arteries and veins was studied with pulse durations in the range of 1 μs to 10 ms and repetition rate of 10 Hz. Pulse amplitude of 20 V, duration of 1 ms, and repetition rate of 10 Hz were found sufficient to induce rapid constriction down to 31 ± 2% of the initial diameter, which could be maintained throughout a two-hour treatment. Within one minute following treatment termination the artery dilated back to 88 ± 3% of the initial diameter, providing rapid restoration of blood perfusion. Histology indicated no damage to the vessel wall and endothelium seven days after stimulation. The same treatment reduced the blood loss following complete femoral artery resection by 68 ± 11%, compared to untreated vessels. Very low power consumption during stimulation (<10 mW per 1.6 mm electrode) allows miniaturization of the stimulator for portable battery-powered operation in the field to control the blood loss following vascular trauma.

The role of endogenous norepinephrine release in potassium-evoked vasoconstriction of the rat tail artery

Potassium-containing solutions are often used to study the sequence of events leading from excitation to vasoconstriction. In densely innervated vessels, such as the rat tail artery, potassium-induced vasoconstriction may be mediated via smooth muscle depolarization and release of endogeneous norepinephrine. The relative contribution of these two mechanisms--a 'direct' depolarization of the vascular smooth muscle cell membrane, and an 'indirect' sympathomimetic action--to the vasoconstrictor response was studied in the present paper. Perfusion/superfusion of the rat tail artery in vitro with potassium-containing solutions had different effects depending on the concentration used. A change in potassium concentration from 4.7 to 20 mM had no effect on either perfusion pressure or norepinephrine overflow. From 30 to 70 mM, potassium produced increasing amounts of norepinephrine overflow. Experiments with phentolamine and reserpine showed that this norepinephrine overflow contributed for up to half of the vasoconstrictor response observed. A second norepinephrine-independent mechanism was also involved but the latter appeared to be incapable of producing sustained contraction. At concentrations of potassium above 50-70 mM, the results of experiments with (+/-)-propranolol suggest that the norepinephrine released by potassium has a beta-adrenoceptor-mediated vasorelaxant effect.

Differences between the in vitro vasoconstrictor responses of the tail artery to potassium and norepinephrine between spontaneously hypertensive, renovascular hypertensive, and various strains of normotensive rats

Isolated tail arteries removed from spontaneously hypertensive, renovascular hypertensive, or various strains of normotensive rats were perfused/superfused with norepinephrine or potassium, or subjected to electrical field stimulation. Responses in spontaneously hypertensive and outbred normotensive rat tail artery preparations were similar. Tail artery segments from renovascular hypertensive or normotensive rats of the inbred Wistar-Kyoto strain showed smaller responses to all three stimuli. Thus, in certain in vitro arterial preparations, the apparent increase in vascular reactivity observed when comparing spontaneously hypertensive rats with inbred Wistar-Kyoto rats may be due to a decrease in vascular reactivity in the Wistar-Kyoto rat strain.

In vitro vasoconstriction induced by calcium in renovascular hypertensive or old rats

We studied the changes in calcium-induced vasoconstriction in isolated tail arteries from young (2 months) and old (12 months) normotensive, and young renovascular hypertensive rats (3 months old, with unilateral renal artery clipping at 6 weeks), pretreated with reserpine. The tail artery was removed and perfused/superfused with either a high potassium Krebs depolarizing solution or Krebs solution plus phenylephrine. Concentration-response curves to calcium were produced. Old rats had a low plasma renin activity and their depolarized tail arteries showed a weak vasoconstrictor response to calcium. Renovascular hypertensive rats had a high mean blood pressure and plasma renin activity. Responses of their depolarized tail arteries to calcium were greater. Responses to calcium in tail arteries perfused with phenylephrine were similar in all groups. We conclude that age and renovascular hypertension produce opposite changes in vasoconstriction induced by calcium in depolarized tail arteries.

Alpha-1 and alpha-2 adrenoceptor agonists induce vasoconstriction of the normotensive rat caudal artery in vitro by stimulation of a heterogeneous population of alpha-1 adrenoceptors

Although alpha-2 adrenoceptor agonists rapidly induce arterial vasoconstriction in vivo, such responses have proven difficult to obtain in vitro. We have investigated the vasoconstrictor effects of various alpha-1 and alpha-2 adrenoceptor agonists in the perfused superfused caudal artery of the normotensive rat. Intrinsic activities were; methoxamine; 1, phenylephrine; 0.94, noradrenaline; 0.93, guanfacine; 0.88, clonidine; 0.47, UK 14,304 [5-bromo-6-(2-imidazoline-2-ylamino)-quinoxaline tartrate]: 0.10, azepexole; 0. Antagonism by the selective alpha-1 agent, prazosin of the vasoconstrictor responses provoked by methoxamine, guanfacine or clonidine, showed a high affinity with--log KB values in the range of 8.5 to 9.4. There were no significant differences between the KB values obtained with the three agonists. Antagonism by the selective alpha-2 antagonist, yohimbine showed a low affinity with KB values between 6.7 to 7.6 for the three agonists. The calcium entry blocker, nicardipine, antagonized responses to clonidine at nanomolar concentrations and those to phenylephrine at micromolar concentrations. We conclude that vasoconstrictor responses in this isolated tail artery preparation are primarily mediated via an alpha adrenoceptor which can be classified, on the basis of the results with specific antagonists, as being of the alpha-1 type. The results obtained with nicardipine suggest that the population of alpha adrenoceptors is not, however, homogeneous.