RESUMO
Abstract Background: Isotonic blood volume expansion (BVE) induced alterations of sympathetic and parasympathetic activity in the heart and blood vessels, which can be modulated by serotonergic pathways. Objective: To evaluate the effect of saline or serotonergic agonist (DOI) administration in the hypothalamic paraventricular nucleus (PVN) on cardiovascular responses after BVE. Methods: We recorded pulsatile blood pressure through the femoral artery to obtain the mean arterial pressure (MAP), systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and the sympathetic-vagal ratio (LF/HF) of Wistar rats before and after they received bilateral microinjections of saline or DOI into the PVN, followed by BVE. Results: No significant differences were observed in the values of the studied variables in the different treatments from the control group. However, when animals are treated with DOI followed by BVE there is a significant increase in relation to the BE control group in all the studied variables: MBP (114.42±7.85 vs 101.34±9.17); SBP (147.23±14.31 vs 129.39±10.70); DBP (98.01 ±4.91 vs 87.31±8.61); HR (421.02±43.32 vs 356.35±41.99); and LF/HF ratio (2.32±0.80 vs 0.27±0.32). Discussion: The present study showed that the induction of isotonic BVE did not promote alterations in MAP, HR and LF/HF ratio. On the other hand, the injection of DOI into PVN of the hypothalamus followed by isotonic BVE resulted in a significant increase of all variables. Conclusion: These results suggest that serotonin induced a neuromodulation in the PVN level, which promotes an inhibition of the baroreflex response to BVE. Therefore, the present study suggests the involvement of the serotonergic system in the modulation of vagal reflex response at PVN in the normotensive rats.
Resumo Fundamento: Expansão de volume extracelular (EVEC) promove alterações da atividade simpática e parassimpática no coração e vasos sanguíneos, os quais podem ser moduladas por vias serotoninérgicas. Objetivo: Avaliar o efeito da administração de salina ou agonista serotoninérgico (DOI) nos núcleos paraventriculares hipotalâmico (NPV) sobre respostas cardiovasculares após EVEC. Métodos: Foram obtidos registros da pressão arterial pulsátil, por meio da artéria femoral, para obtenção dos valores da pressão arterial média (PAM), sistólica (PAS), diastólica (PAD), frequência cardíaca (FC) e razão simpático-vagal (LF/HF) de ratos Wistar antes e após receberem microinjeções bilaterais no NPV de salina ou DOI seguida de EVEC. Resultados: Não foram observadas diferenças significativas dos valores das variáveis estudadas nos diferentes tratamentos do grupo controle. Entretanto, quando os animais são tratados com DOI seguida de EVEC ocorre aumento significativo em relação ao grupo controle com EVEC em todas as variáveis estudadas: PAM (114,42±7,85 vs 101,34±9,17), PAS (147,23±14,31 vs 129,39±10,70), PAD (98,01 ±4,91 vs 87,31±8,61), FC (421,02±43,32 vs 356,35±41,99) e LF/HF (2,32±0,80 vs 0,27±0,32). Discussão: O presente estudo mostrou que a indução de EVEC isotônica não promoveu alterações na PAM, PAD, PAS, FC e LF/HF. Por outro lado, os animais que receberam microinjeção de DOI no NPV seguida de EVEC apresentaram aumento significativo de todas as variáveis. Conclusão: Esses resultados sugerem que a serotonina exerce uma neuromodulação em nivel do NPV, e essa promove uma inibição da resposta barorreflexa frente à EVEC. Assim, o presente trabalho sugere o envolvimento serotoninérgico na neuromodulação no nivel do NPV na resposta reflexa vagal em ratos normotensos.
Assuntos
Animais , Masculino , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Núcleo Hipotalâmico Paraventricular/fisiologia , Volume Sanguíneo/efeitos dos fármacos , Cloreto de Sódio/farmacologia , Sistema Cardiovascular/efeitos dos fármacos , Agonistas do Receptor de Serotonina/farmacologia , Valores de Referência , Fatores de Tempo , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Volume Sanguíneo/fisiologia , Fenômenos Fisiológicos Cardiovasculares , Reprodutibilidade dos Testes , Ratos Wistar , Barorreflexo/efeitos dos fármacos , Barorreflexo/fisiologia , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologiaRESUMO
ABSTRACT PURPOSE: To evaluate the effects of dobutamine (DB), noradrenaline (NA), and their combination (NADB), on volume retention in rabbits submitted to hemorrhage. METHODS: Thirty six rabbits were randomly divided into 6 groups: SHAM, Control, Saline, DB, NA, DB+NA. All the animals, except for SHAM, were subjected to hemorrhage of 25% of the calculated blood volume. Control animals were replaced with their own blood. The other groups received NSS 3 times the volume withdrawn. The intravascular retention, hematocrit, diuresis, central venous pressure, mean arterial pressure, NGAL, dry-to-wet lung weight ratio (DTWR) and the lung and kidney histology were analyzed. RESULTS: Replacement with NSS and NA, DB or NA+DB did not produce differences in the intravascular retention. After hemorrhage, the animals presented a significant decrease in the MAP and CVP, which were maintained until volume replacement. Regarding NGAL, dry-to-wet-lung-weight ratio, lung and kidney histology, there were no statistical differences between the groups. CONCLUSION: The use of noradrenaline, dobutamine or their combination did not increase the intravascular retention of volume after normal saline infusion.
Assuntos
Animais , Coelhos , Volume Sanguíneo/efeitos dos fármacos , Cloreto de Sódio/administração & dosagem , Norepinefrina/administração & dosagem , Agonistas Adrenérgicos beta/administração & dosagem , Dobutamina/administração & dosagem , Hemorragia/fisiopatologia , Fatores de Tempo , Infusões Intravenosas , Distribuição Aleatória , Combinação de Medicamentos , Hematócrito , Rim/efeitos dos fármacos , Pulmão/efeitos dos fármacosRESUMO
PURPOSE: To verify the effects of different catecholamines on volemic expansion and on the autonomic nervous system in rabbits that were subjected to hemorrhage. METHODS: Twenty four rabbits subjected to hemorrhage (with a 25% loss of blood volume) and were randomly divided into four experimental groups: 1) HEMO Group underwent replacement with their own blood in an equal volume; 2) SS Group underwent replacement with saline solution (SS) in a volume that corresponded to three times the removed blood volume; 3) ISP Group underwent replacement with SS and isoprenaline; 4) FNL Group underwent replacement with SS and phenylephrine. Spectral Analysis of the heart rate and heart rate variability were performed from the recorded data. Hematocrit was measured throughout the experiment. RESULTS: Replacement with SS and an α- or β-agonist did not produce differences in the intravascular retention compared to replacement with SS alone. An analysis of HRV showed that the FNL group maintained the LF/HF ratio better than ISP and SS. CONCLUSIONS: No difference in vascular retention when α- or β- agonists were added to SS during post-hemorrhagic recovery. The animals in the FNL group maintained the integrity of the autonomic response within normal physiological standards during hemorrhagic stress. .
Assuntos
Animais , Coelhos , Volume Sanguíneo/efeitos dos fármacos , Catecolaminas/farmacologia , Frequência Cardíaca/efeitos dos fármacos , Hemorragia/fisiopatologia , Cloreto de Sódio/farmacologia , Agonistas de Receptores Adrenérgicos alfa 1/farmacologia , Agonistas Adrenérgicos beta/farmacologia , Sistema Nervoso Autônomo/efeitos dos fármacos , Transfusão de Sangue Autóloga , Análise de Fourier , Hematócrito , Frequência Cardíaca/fisiologia , Hemorragia/etiologia , Hemorragia/terapia , Isoproterenol/farmacologia , Fenilefrina/farmacologia , Distribuição Aleatória , Valores de Referência , Reprodutibilidade dos Testes , Análise Espectral , Fatores de TempoRESUMO
OBJECTIVE: The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass. METHODS: Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer's acetate 1470 ml and mannitol 15% 200 ml) and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: NCT01115166. RESULTS: The distribution half-time of Ringer's acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean) at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p<0.02). The mass balance of sodium indicated a translocation from the intracellular to the extracellular fluid space in 8 of the 10 patients, with a median volume of 236 ml. CONCLUSIONS: The distribution half-time of Ringer's solution during isovolumetric cardiopulmonary bypass was 8 minutes, which is the same as for crystalloid fluid infusions in healthy subjects. The intravascular albumin mass increased. Most patients were hypovolemic prior to the start of anesthesia. Intracellular edema did not occur. .
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Volume Sanguíneo/fisiologia , Ponte Cardiopulmonar , Soluções Isotônicas/farmacocinética , Volume Sanguíneo/efeitos dos fármacos , Edema Encefálico/etiologia , Ponte de Artéria Coronária , Espaço Extracelular/metabolismo , Deslocamentos de Líquidos Corporais/efeitos dos fármacos , Deslocamentos de Líquidos Corporais/fisiologia , Hemoglobinas/análise , Manitol/farmacologia , Estudos Prospectivos , Albumina Sérica/análise , Sódio/sangue , Sódio/urina , Equilíbrio Hidroeletrolítico/fisiologiaRESUMO
PURPOSE: To describe an animal model of rapid intravenous infusion with different volumes of crystalloid and discuss the clinical findings. METHODS: Fifty six male Wistar rats were used, divided randomly in seven groups (n = 8). The rats of groups 1 to 6 received lactated Ringer´s solution intravenously, in the rate of 25 ml/min, with different volumes proportional to blood volume (BV). The rats of group 0 were submitted to the same procedure, but did not receive the fluid (control group). The data included respiratory rate, heart rate, saturation of peripheral oxygen (SpO2) in two times (before and after the infusion), and upshots (respiratory arrest and death). Dunnett´s test and ANOVA were used. RESULTS: The clinical signs significantly changed in the 2, 2.5 and 3 fold BV groups. The respiratory arrest was observed in the 1.5, 2, 2.5 and 3 fold BV groups, but death was present only in 2.5 and 3 fold BV groups. CONCLUSIONS: The infusion of crystalloid in the same volume of blood volume did not cause significant variation in respiratory and heart rate, saturation of peripheral oxygen and did not induce respiratory arrest. The infusion of a volume of 3 fold blood volume was lethal to all animals.
Assuntos
Animais , Masculino , Ratos , Hidratação/métodos , Soluções Isotônicas/administração & dosagem , Modelos Animais , Volume Sanguíneo/efeitos dos fármacos , Frequência Cardíaca , Infusões Intravenosas/métodos , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes , Taxa Respiratória/efeitos dos fármacosRESUMO
INTRODUÇÃO: O ácido épsilon aminocapróico é um antifibrinolítico usado em cirurgia cardiovascular a fim de inibir a fibrinólise e reduzir o sangramento após circulação extracorpórea (CEC). OBJETIVO: Analisar a influência do uso do ácido aminocapróico no sangramento e na necessidade de hemotransfusão nas primeiras 24 horas em pós-operatório de cirurgias valvares mitrais. MÉTODOS: Estudo prospectivo, 42 pacientes, randomizados e divididos em dois grupos, de igual número: grupo I - controle e grupo II - ácido épsilon aminocapróico. No grupo II, foram infundidos 5 gramas de AEAC na indução anestésica, após heparinização plena, no perfusato da CEC, após reversão da heparina e uma hora após o final da cirurgia, totalizando 25 gramas. No grupo I, foi infundido apenas soro fisiológico nestes mesmos momentos. RESULTADOS: O grupo I apresentou volume de sangramento médio de 633,57 ± 305,7 ml e o grupo II média de 308,81 ± 210,1 ml, com diferença estatisticamente significativa (P=0,0003). O volume médio de hemotransfusão nos grupos I e II foi, respectivamente, de 942,86 ± 345,79 ml e de 214,29 ± 330,58 ml, havendo diferença significativa (P<0,0001). CONCLUSÃO: O ácido épsilon aminocapróico foi capaz de reduzir o volume de sangramento e a necessidade de hemoderivados no pós-operatório imediato de pacientes submetidos a cirurgias valvares mitrais.
INTRODUCTION: The epsilon aminocaproic acid is an antifibrinolytic used in cardiovascular surgery to inhibit the fibrinolysis and to reduce the bleeding after CBP. OBJECTIVE: To analyze the influence of the using of epsilon aminocaproic acid in the bleeding and in red-cell transfusion requirement in the first twenty-four hours postoperative of mitral valve surgery. METHODS: Prospective studying, forty-two patients, randomized and divided in two equal groups: group #1 control and group #2 - epsilon aminocaproic acid. In Group II were infused five grams of EACA in the induction of anesthesia, after full heparinization, CPB perfusate after reversal of heparin and one hour after the surgery, totaling 25 grams. In group I, saline solution was infused only in those moments. RESULTS: Group #1 showed average bleeding volume of 633.57 ± 305,7 ml, and Group #2, an average of 308.81 ± 210.1 ml, with significant statistic difference (P=0.0003). Average volume of red-cell transfusion requirement in Groups 1 and 2 was, respectively, 942.86 ± 345.79 ml and 214.29 ± 330.58 ml, with significant difference (P<0.0001). CONCLUSION: The epsilon aminocaproic acid was able to reduce the bleeding volume and the red-cell transfusion requirement in the immediate postoperative of patients submitted to mitral valve surgery.
Assuntos
Humanos , /administração & dosagem , Antifibrinolíticos/administração & dosagem , Perda Sanguínea Cirúrgica/prevenção & controle , Transfusão de Sangue/estatística & dados numéricos , Volume Sanguíneo/efeitos dos fármacos , Valva Mitral/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Métodos EpidemiológicosRESUMO
OBJECTIVE: To test the hypothesis that pulse pressure respiratory variation (PPV) amplification, observed in hypovolemia, can also be observed during sodium nitroprusside (SNP)-induced vasodilation. INTRODUCTION: PPV is largely used for early identification of cardiac responsiveness, especially when hypovolemia is suspected. PPV results from respiratory variation in transpulmonary blood flow and reflects the left ventricular preload variations during respiratory cycles. Any factor that decreases left ventricular preload can be associated with PPV amplification, as seen in hypovolemia. METHODS: Ten anesthetized and mechanically ventilated rabbits underwent progressive hypotension by either controlled hemorrhage (Group 1) or intravenous SNP infusion (Group 2). Animals in Group 1 (n = 5) had graded hemorrhage induced at 10 percent steps until 50 percent of the total volume was bled. Mean arterial pressure (MAP) steps were registered and assumed as pressure targets to be reached in Group 2. Group 2 (n = 5) was subjected to a progressive SNP infusion to reach similar pressure targets as those defined in Group 1. Heart rate (HR), systolic pressure variation (SPV) and PPV were measured at each MAP step, and the values were compared between the groups. RESULTS: SPV and PPV were similar between the experimental models in all steps (p > 0.16). SPV increased earlier in Group 2. CONCLUSION: Both pharmacologic vasodilation and graded hemorrhage induced PPV amplification similar to that observed in hypovolemia, reinforcing the idea that amplified arterial pressure variation does not necessarily represent hypovolemic status but rather potential cardiovascular responsiveness to fluid infusion.
Assuntos
Animais , Masculino , Coelhos , Pressão Sanguínea/efeitos dos fármacos , Volume Sanguíneo/efeitos dos fármacos , Hipovolemia/fisiopatologia , Choque Hemorrágico/fisiopatologia , Pressão Sanguínea/fisiologia , Volume Sanguíneo/fisiologia , Modelos Animais de Doenças , Nitroprussiato/farmacologia , Choque Hemorrágico/induzido quimicamente , Vasodilatação/efeitos dos fármacos , Vasodilatação/fisiologiaRESUMO
Objetive: This study evaluated retroperitoneal hematomas produced by bilateral injury of iliac arteries (uncontrolled hemorrhage), blood volume loss, transcapillary refill, the effects of volume replacement on retroperitoneal bleeding and the hemodynamic changes with and without treatment. Methods: Initial blood volume was determined with Tc99m-labelled red cells, and bleeding was evaluated by means of a portable scintillation camera positioned over the abdomen. Previously splenectomized mongrel dogs (16.8 ± 2.2 kg) were submitted to hemorrhage for 30 minutes and randomized into three groups: I - no treatment (n=7); II - treatment with 32 mL/kg of Lactated Ringer's for three to five minutes (n=7); and III - treatment with 4 mL/kg of 7.5 percent NaCl plus 6.0 percent dextran 70 for three to five minutes (n=7). They were studied for an additional 45 minutes. Results: Volume replacement produced transitory recovery in hemodynamic variables, including mean pulmonary artery pressure, pulmonary capillary wedge pressure and cardiac index, with significant increase in dogs treated with 32 mL/kg of Lactated Ringer's and 7.5 percent NaCl plus 6.0 percent dextran 70 (p<0.001, against no treatment), along with a decrease (p<0.001) in the systemic vascular resistance index. Groups II and III had significant initial decreases in hematocrit and hemoglobin. The treated dogs (groups II and III) presented rebleeding, which was greater during treatment with 32 mL/kg of Lactated Ringer's (group II). Conclusions: Despite the rebleeding observed in treated groups, the utilization of hypertonic saline solution with dextran proved to be effective in the initial reanimation, producing evident transcapillary refill, while the Lactated Ringer's solution produced capillary extravasation and was ineffective in the initial volume replacement in this model of uncontrolled hemorrhage.
Assuntos
Animais , Cães , Masculino , Volume Sanguíneo/efeitos dos fármacos , Dextranos/uso terapêutico , Hidratação/métodos , Hemorragia Gastrointestinal/tratamento farmacológico , Hematoma/tratamento farmacológico , Análise de Variância , Capilares/efeitos dos fármacos , Modelos Animais de Doenças , Hidratação/normas , Hemorragia Gastrointestinal/fisiopatologia , Hematoma/fisiopatologia , Hemodinâmica/efeitos dos fármacos , Artéria Ilíaca/lesões , Soluções Isotônicas/uso terapêutico , Distribuição Aleatória , Espaço Retroperitoneal/irrigação sanguínea , Solução Salina Hipertônica/uso terapêutico , Choque Hemorrágico/tratamento farmacológicoRESUMO
We investigated the involvement of GABAergic mechanisms of the central amygdaloid nucleus (CeA) in unanesthetized rats subjected to acute isotonic or hypertonic blood volume expansion (BVE). Male Wistar rats bearing cannulas unilaterally implanted in the CeA were treated with vehicle, muscimol (0.2 nmol/0.2 µL) or bicuculline (1.6 nmol/0.2 µL) in the CeA, followed by isotonic or hypertonic BVE (0.15 or 0.3 M NaCl, 2 mL/100 g body weight over 1 min). The vehicle-treated group showed an increase in sodium excretion, urinary volume, plasma oxytocin (OT), and atrial natriuretic peptide (ANP) levels compared to control rats. Muscimol reduced the effects of BVE on sodium excretion (isotonic: 2.4 ± 0.3 vs vehicle: 4.8 ± 0.2 and hypertonic: 4.0 ± 0.7 vs vehicle: 8.7 ± 0.6 µEq·100 g-1·40 min-1); urinary volume after hypertonic BVE (83.8 ± 10 vs vehicle: 255.6 ± 16.5 µL·100 g-1·40 min-1); plasma OT levels (isotonic: 15.3 ± 0.6 vs vehicle: 19.3 ± 1 and hypertonic: 26.5 ± 2.6 vs vehicle: 48 ± 3 pg/mL), and ANP levels (isotonic: 97 ± 12.8 vs vehicle: 258.3 ± 28.1 and hypertonic: 160 ± 14.6 vs vehicle: 318 ± 16.3 pg/mL). Bicuculline reduced the effects of isotonic or hypertonic BVE on urinary volume and ANP levels compared to vehicle-treated rats. However, bicuculline enhanced the effects of hypertonic BVE on plasma OT levels. These data suggest that CeA GABAergic mechanisms are involved in the control of ANP and OT secretion, as well as in sodium and water excretion in response to isotonic or hypertonic blood volume expansion.
Assuntos
Animais , Masculino , Ratos , Tonsila do Cerebelo/efeitos dos fármacos , Bicuculina/farmacologia , Volume Sanguíneo/efeitos dos fármacos , Agonistas GABAérgicos/farmacologia , Antagonistas GABAérgicos/farmacologia , Muscimol/farmacologia , Tonsila do Cerebelo/fisiologia , Fator Natriurético Atrial/sangue , Bicuculina/administração & dosagem , Volume Sanguíneo/fisiologia , Diurese/efeitos dos fármacos , Diurese/fisiologia , Agonistas GABAérgicos/administração & dosagem , Antagonistas GABAérgicos/administração & dosagem , Muscimol/administração & dosagem , Ocitocina/sangue , Ratos Wistar , Sódio/urinaRESUMO
We analyzed the effects of saline infusion for the maintenance of blood volume on pulmonary gas exchange in ischemia-reperfusion syndrome during temporary abdominal aortic occlusion in dogs. We studied 20 adult mongrel dogs weighing 12 to 23 kg divided into two groups: ischemia-reperfusion group (IRG, N = 10) and IRG submitted to saline infusion for the maintenance of mean pulmonary arterial wedge pressure between 10 and 20 mmHg (IRG-SS, N = 10). All animals were anesthetized and maintained on spontaneous ventilation. After obtaining baseline measurements, occlusion of the supraceliac aorta was performed by the inflation of a Fogarty catheter. After 60 min of ischemia, the balloon was deflated and the animals were observed for another 60 min of reperfusion. The measurements were made at 10 and 45 min of ischemia, and 5, 30, and 60 min of reperfusion. Pulmonary gas exchange was impaired in the IRG-SS group as demonstrated by the increase of the alveolar-arterial oxygen difference (21 ± 14 in IRG-SS vs 11 ± 8 in IRG after 60 min of reperfusion, P = 0.004 in IRG-SS in relation to baseline values) and the decrease of oxygen partial pressure in arterial blood (58 ± 15 in IRG-SS vs 76 ± 15 in IRG after 60 min of reperfusion, P = 0.001 in IRG-SS in relation to baseline values), which was correlated with the highest degree of pulmonary edema in morphometric analysis (0.16 ± 0.06 in IRG-SS vs 0.09 ± 0.04 in IRG, P = 0.03 between groups). There was also a smaller ventilatory compensation of metabolic acidosis after the reperfusion. We conclude that infusion of normal saline worsened the gas exchange induced by pulmonary reperfusion injury in this experimental model.
Assuntos
Animais , Masculino , Cães , Volume Sanguíneo , Volume Sanguíneo/efeitos dos fármacos , Troca Gasosa Pulmonar/efeitos dos fármacos , Traumatismo por Reperfusão/fisiopatologia , Cloreto de Sódio/farmacologia , Aorta Abdominal/fisiopatologia , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Frequência Cardíaca/efeitos dos fármacos , Infusões Intra-Arteriais , Resistência Vascular/efeitos dos fármacosRESUMO
OBJETIVO: Investigar, em ratos, o efeito da S(+)cetamina na histologia renal após hemorragia intra-operatória.MÉTODOS: Vinte ratos Wistar machos, anestesiados com pentobarbital sódico, foram divididos, aleatoriamente, em 2 grupos: G1 controle (n=10) e G2 - S(+)cetamina (n=10), submetidos a hemorragia de 30% da volemia em 3 momentos (10% a cada 10 min) 60 min após anestesia. G2 recebeu S(+)cetamina, 15 mg. kg-1, i.m., 5 min após anestesia e 55 min antes do 1.º momento de hemorragia (M1). Foram monitorizadas a pressão arterial média (PAM), temperatura retal (T) e freqüência cardíaca. Os animais foram sacrificados (M4) 30 min após o 3.º momento de hemorragia (M3). Os rins e o sangue das hemorragias foram utilizados para estudo histológico e do hematócrito (Ht). RESULTADOS: Houve redução significativa da PAM, T e Ht. Na histologia, G1=G2 na dilatação tubular, congestão e necrose. A soma total dos escores foi significativamente diferente e G2>G1. CONCLUSÃO: Hemorragia e hipotensão determinaram alterações na histologia renal. O aumento da concentração sangüínea de catecolaminas provavelmente determinou escores mais altos de alterações histológicas com o uso de S(+)cetamina.
Assuntos
Animais , Masculino , Ratos , Anestésicos Dissociativos/farmacologia , Hemorragia/fisiopatologia , Complicações Intraoperatórias/fisiopatologia , Isquemia/fisiopatologia , Ketamina/farmacologia , Rim/efeitos dos fármacos , Adjuvantes Anestésicos/farmacologia , Anestésicos Dissociativos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Volume Sanguíneo/efeitos dos fármacos , Volume Sanguíneo/fisiologia , Estudos de Casos e Controles , Modelos Animais de Doenças , Hipotensão/etiologia , Hipotensão/fisiopatologia , Hipovolemia/complicações , Hipovolemia/fisiopatologia , Ketamina/uso terapêutico , Rim/irrigação sanguínea , Rim/fisiopatologia , Pentobarbital/farmacologia , Distribuição Aleatória , Ratos Wistar , Estatísticas não ParamétricasRESUMO
O uso de soluções hipertônicas para reanimação de pacientes em choque é um conceito relativamente novo. Baseou-se originalmente na idéia de que uma expansão volêmica significativa podia ser obtida às custas de um volume relativamente diminuto de infusão, aproveitando a propriedade física de osmose. Logo ficou claro que a capacidade fisiológica de produzir vasodilatação, compartilhada por todas as soluções hipertônicas, seria valiosa para reperfundir territórios tornados isquêmicos pelo choque, embora os malefícios da seqüência isquemia - reperfusão devessem ser considerados. Pesquisa subseqüente revelou propriedades antes insuspeitadas da reanimação hipertônica. Verificou-se que este procedimento revertia instantaneamente o edema endotelial e de hemácias, com importantes conseqüências em termos de circulação capilar. Mais recentemente, um conjunto de efeitos da hipertonicidade sobre o sistema imune vem sendo estudado, mas as possíveis implicações destas descobertas em relação ao cenário clínico ainda suscitam discussão. As soluções hipertônicas estão em uso em algumas partes do mundo, apesar de objeções levantadas contra tal uso, em virtude de dados experimentais derivados de experimentos de hemorragia não controlada. Tais objeções não parecem se justificar em face dos resultados obtidos numa série de ensaios clínicos e no uso corrente destas soluções. Esta revisão procura cobrir um pouco da história, remota e recente, deste campo do conhecimento.
Assuntos
Humanos , Ressuscitação/métodos , Solução Salina Hipertônica/administração & dosagem , Choque/tratamento farmacológico , Volume Sanguíneo/efeitos dos fármacos , Dextranos/administração & dosagem , Dextranos/efeitos adversos , Hemodinâmica , Solução Salina Hipertônica/efeitos adversosRESUMO
Ovarian blood volume was quantified by measuring optical density (414 nm) of haemoglobin in ovarian extracts and comparing it with that of known amounts of whole blood in the cyclic mature female rats during estrous cycle and periovulatory period. Haemoglobin in ovarian extracts had the same peak absorbance of 414 nm characteristic of oxyhaemoglobin in whole blood taken by cardiac puncture of the rats. There was a linear relationship between the absorbance and volume of whole blood in the sample. The ovarian blood volume was lowest on the day of metestrus and slightly increased on the day of diestrus. On the night of proestrus, the blood volume significantly increased and showed a gradual increase during preovulatory period from 0030 hrs to 0230 hrs and then started decreasing and reached a preovulatory level on the morning of estrus. Ovulation had occurred only in the rats sacrificed after 0230 hrs. Treatment of rats with indomethacin and propranolol significantly reduced the ovarian blood volume observed during the ovulatory period. Epinephrine and norepinephrine did not affect the ovarian blood volume. The results show that the ovarian blood volume changes significantly during the estrous cycle and reaches at maximum level at the time of ovulation which perhaps reflect vasodilatation and hyperemia associated with this process.
Assuntos
Animais , Volume Sanguíneo/efeitos dos fármacos , Epinefrina/farmacologia , Estro/fisiologia , Feminino , Indometacina/farmacologia , Norepinefrina/farmacologia , Ovário/irrigação sanguínea , Ovulação/fisiologia , Propranolol/farmacologia , RatosRESUMO
Experiments were performed on anaesthetized artificially ventilated cats to study the effects of phenylephrine (PE) on cardiovascular responsiveness, before and after induction of experimental anaemia. Acute anaemia was induced by replacement of blood by dextran in three steps of 20% each of total estimated blood volume. The effect of PE (20 micrograms/kg) was investigated at four stages: control and after 1st, 2nd and 3rd exchanges of blood. Induction of anaemia produced a significant increase in heart rate (HR) and cardiac output (CO) and a decrease in right atrial pressure (RAP). No significant change in mean arterial pressure (MAP), LV dP/dt max and blood gas tension was observed. Administration of bolus dose of PE produced a rapid rise in MAP, LVdP/dt max, and a decrease in HR without a change in the RAP. The pattern of response to PE was similar after induction of acute anaemia, however the magnitude of the response was significantly reduced. The attenuation in the response to PE was related to the fall in the haematocrit (HCT) level. This shows that induction of experimental anaemia, produced an increase in CO due to an increase in HR and SV and the effect of PE on cardiovascular responsiveness was significantly attenuated. The reduced sensitivity to PE during acute anaemia could be due to many factors such as inadequate O2 supply, effect of local vasodilating agents or some other cardiotonic agents which are known to contribute to vascular responsiveness.
Assuntos
Doença Aguda , Análise de Variância , Anemia/induzido quimicamente , Animais , Pressão Sanguínea/efeitos dos fármacos , Substitutos Sanguíneos/administração & dosagem , Volume Sanguíneo/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Gatos , Dextranos/administração & dosagem , Modelos Animais de Doenças , Feminino , Frequência Cardíaca/efeitos dos fármacos , Hematócrito , Hemodiluição/efeitos adversos , Masculino , Fenilefrina/administração & dosagemRESUMO
Since stimulation of the anteroventral third ventricle region (AV3V) induced a rapid elevation of plasma atrial natriuretic peptide (ANP) associated with rapid changes in brain and pituitary content of ANP, whereas lesions of the AV3V were followed by marked by a merked decline in plasma, brain and pituitary content of the peptide, we hypothesized that release of ANP from the median eminence (ME) might be an important pathway to control plasma ANP. Consequently, electrolytic lesions were placed in the ME and the response to hypertonic-expansion was determined in conscieous rats. In sham-operated controls volume expansion produced a 3.5-fold increase in plasma ANP concentrations within 5 min. Values rapidly declined to enar initial levels at 15 and 30 min. Median eminence lesions almost completely blocked the response to volume expansion at 24 and 120 h post-lesion and initial anp concentrations were lower than those of the sham-operated controls. The results indicate that increased release of ANP from the neurohypophysis may play an important role in the increased plasma ANP concentrations whic follow volume expansion