Investigating the relationship between hemodynamic and metabolic parameters in portal triade occlusion following hemorrhagic shock

A fatal and metabolic experimental hemorrhagic shock in immature swine

PURPOSE

To use blood lactate (BL) as an end-point metabolic marker for the begin resuscitation of volume replacement in experimental hemorrhagic shock.

METHODS

Group I (n=7) was not bled (Control). Animals in Group II (n=7) were bled to a MAP of 30mmHg in thirty minutes. Hemodynamic and metabolic data were recorded at Baseline, at 30, 60 and 120 minutes after Baseline. The animals were intubated in spontaneous breathing (FIO2=0.21) with halothane.

RESULTS

Group I all survived. In Group II all died; no mortality occurred before a BL<10mM/L. Beyond the end-point all animals exhibited severe acidemia, hyperventilation and clinical signs of shock. Without treatment all animals died within 70.43±24.51 min of hypotension shortly after reaching an average level of BL 17.01±3.20mM/L.

CONCLUSIONS

Swine's breathing room air spontaneously in hemorrhagic shock not treated a blood lactate over 10mM/L results fatal. The predictable outcome of this shock model is expected to produce consistent information based on possible different metabolic and hemodynamic patterns as far as the type of fluid and the timing of resuscitation in near fatal hemorrhagic shock.

Evaluation of the mortality rate caused by different periods of selective portal vein occlusion in rats

Mortality from acute selective portal vein occlusion (SPVO) is a matter of concern for surgeons during the management of traumatic portal vein injury. However, mortality rates related to different periods of SPVO remains undetermined.

PURPOSE

To determine the mortality rates resulting from different periods of acute SPVO in rats.

METHODS

Wistar male rats were randomized into 8 experimental, and 8 control groups. Experimental animals underwent SPVO during 15 to 75 minutes, and control groups underwent sham procedures. All surviving animals were followed up to 14 days for assessment of mortality rate.

RESULTS

Death rates varied from 0% in the 15 min SPVO group, to 100% with 65 and 75 minutes of SPVO. A strongly positive correlation was observed between mortality rates and SPVO periods (p<0.001) with either linear or quadratic regression analysis tests. All deaths in the 20 min and 25 min SPVO groups occurred after 75 min from the moment of clamping (or after 60 min from unclamping); death from 30 or more min SPVO occurred predominantly within 75 min from clamping moment (or within 60 min from unclamping). (Exact Fisher test, p=0.009).

CONCLUSIONS

The mortality from SPVO in rats increases with longer duration of SPVO; with deaths occurring later for short periods (<or= 25 min) of SPVO and earlier for longer periods (>or= 30 min) of SPVO.