Electrolyte studies in experimental animals during hypothermia

The effects of antishock trouser inflation during hypothermic cardiovascular depression in the canine model

The purpose of this study was to investigate the value and to identify any deleterious effects of antishock trouser use during hypothermic cardiovascular depression. Thirteen mongrels were made hypotensive by cooling to a core temperature of approximately 27 degrees C. Eight dogs had antishock trousers inflated for one hour and five dogs served as controls. Metabolic and hemodynamic variables were measured at regular intervals during cooling, during trouser inflation, and after trouser deflation. No study animal experienced ventricular fibrillation. Neither central temperature, pH, or serum potassium nor mean arterial BP or systemic vascular resistance were significantly affected by trouser inflation or deflation. Antishock trouser use during the early phase of hypothermia before rewarming does not appear to result in a central bolus of cold, acidotic, hyperkalemic blood or the precipitation of ventricular fibrillation. There appears to be no significant hemodynamic benefit of antishock trouser use early in the management of hypotension caused by moderate hypothermia.

RENAL CLEARANCE OF SODIUM AND POTASSIUM IN HYPOTHERMIA

The handling of sodium and potassium by the renal tubules at various levels of hypothermia was studied. Fourteen dogs were anesthetized with 30 mg/kg sodium pentobarbital. After suitable control clearance measurements, the rectal temperature was lowered progressively by ice-packing to about 25 °C while renal clearances were continuously measured. Artificial respiration was not used. No change in plasma sodium was detected but plasma potassium fell significantly from a control value of 4.1 ± 0.09 meq/1. at 38 °C to 3.4 ± 0.12 meq/1. at 25 °C. Urine sodium concentration fell during exposure to cold while potassium concentration increased slightly. In spite of the marked fall in glomerular nitration rate (69.0 ± 3.1 ml/minute control to 17.0 ± 3.6 ml/minute at 25 °C) the final urine flow at 25 °C was slightly greater than that of control. The clearance ratios (in percentage) increased significantly, reflecting the marked decrease in tubular reabsorption: water, 0.49 ± 0.05 at 38 °C to 2.02 ± 0.25 at 25 °C; sodium, 0.47 ± 0.12 to 1.13 ± 0.27; potassium, 18.0 ± 2.6 to 54.0 ± 12.0. The difference in clearance ratio alterations is a reflection of the dissimilar effect of hypothermia on particular renal regulations.

RENAL CLEARANCE OF SODIUM AND POTASSIUM IN HYPOTHERMIA

The handling of sodium and potassium by the renal tubules at various levels of hypothermia was studied. Fourteen dogs were anesthetized with 30 mg/kg sodium pentobarbital. After suitable control clearance measurements, the rectal temperature was lowered progressively by ice-packing to about 25 °C while renal clearances were continuously measured. Artificial respiration was not used. No change in plasma sodium was detected but plasma potassium fell significantly from a control value of 4.1 ± 0.09 meq/1. at 38 °C to 3.4 ± 0.12 meq/1. at 25 °C. Urine sodium concentration fell during exposure to cold while potassium concentration increased slightly. In spite of the marked fall in glomerular nitration rate (69.0 ± 3.1 ml/minute control to 17.0 ± 3.6 ml/minute at 25 °C) the final urine flow at 25 °C was slightly greater than that of control. The clearance ratios (in percentage) increased significantly, reflecting the marked decrease in tubular reabsorption: water, 0.49 ± 0.05 at 38 °C to 2.02 ± 0.25 at 25 °C; sodium, 0.47 ± 0.12 to 1.13 ± 0.27; potassium, 18.0 ± 2.6 to 54.0 ± 12.0. The difference in clearance ratio alterations is a reflection of the dissimilar effect of hypothermia on particular renal regulations.