Injury (nociceptive afferent nerve stimulation) modifies the hemodynamic and metabolic responses to hemorrhage in immature swine.

摘要: Objective To determine the effects of reinfusion shed blood on regional flow changes induced by hemorrhage and plus nociceptive nerve stimulation (injury) with special reference to gut. Design Randomized controlled laboratory study. Setting Medical Research Council laboratory, university medical school. Subjects Four groups anesthetized immature female Large-White pigs (15-27 kg): 30% hemorrhage, afferent stimulation, alone, surgical controls. Interventions In addition standard invasive hemodynamic monitoring, electromagnetic probes were placed around a branch superior mesenteric artery right femoral artery. Stimulating electrodes brachial nerves in both axillae. Animals underwent over 30 mins. After 30-min shock period, was reinfused at 2 mL/kg/min. Measurements main results Measurements/calculations global hemodynamics, gut flows/vascular resistance, metabolism, arterial plasma lactate, portal venous endotoxin, interleukin-6, tumor necrosis factor-alpha made before after reinfusion, intervals for 3 hrs. Blood tissue samples taken presence translocated coliforms. Hemorrhage elicited expected flows. There partial recovery during period. Nearly all metabolic variables rapidly restored reinfusion. The response modified stimulation: Reductions systemic hemodynamics greater, there no phase. Cytokine endotoxin concentrations increased significantly groups. bacterial translocation. Conclusions When occurs (injury), relative protection circulation is attenuated this effect persists end However, evidence that injury hemorrhage/surgery-induced cytokine responses.