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KMID : 0364019730060020131
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Korean Journal of Thoracic and Cardiovascular Surgery
1973 Volume.6 No. 2 p.131 ~ p.142
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Effects of Hypovolemic Hypotension on Cardiopulmonary Functions and Acid-Base Balance
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Abstract
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Studies of cardiopulmonary function and acid-base balance were performed on 29 dogs during control period, during oligemic hypotension and following return of blood to the animals. Intravenous morphine and local anesthesia were used.
Fifteen of the 29 animals survived the complete experiment. The 14 animals that failed to survive the experimental period died between 15 to 90 minutes after the onset of bleeding.
The results were as follows.
1. The heart rate increased after the onset of bleeding and failed to return to control level following reinfusion. Stroke volume decreased markedly after bleeding and failed to recover after return of blood from the reservoir. Cardiac output also decreased during oligemic hypotension and was maintained at this level after re-infusion.
Total peripheral resistance decreased significantly immediately after bleeding, however it increased soon over the pre-bleeding level. Central venous pressure decreased after the onset of bleeding and remained at lower level for the rest of the experimental period. Arterial blood. pressure, down to 40-45 mmHg by acute hemorrhage, was elevated near to control leval. Left ventricular work decreased tremendously during oligemic hypotensioif and failed to return to control level with the re-infusion of blood.
Hematocrit value showed no significant decrease after bleeding and increased after re-infusion. Hemoglobin decreased after the onset of bleeding and recovered to control value after re-infusion.
2. The respiratory rate fell repidly after bleeding from 124 to 29 and remained at this lower level for the remainder of the experiment. The tidal volume increased after bleeding and was maintained at this level for the remainder of the experiment. The respiratory minute volume showed no significant changes throughout the experimental period.
Oxygen consumption fell lightly in all animals during oligemic hypotension and returned to normal levels following re-infusion.
Arterial oxygen content and arterial oxygen saturation decreased following bleeding and the values
returned to normal levels after the return of blood from the reservoir The arterio-venous oxygen difference increased after the onset of bleeding. It failed to return to normal values following re-infusion.
Arterial PCO_(2) decreased in all animals after the beginning of the bleeding. Partial pressure of Co_(2) continued to fall until re-infusion, after which the values returned toward normal.
Animals became acidotic. The pH fell to lower level following bleeding. Lactic acid and lactate: pyruvate ratio also increased during same period. Arterial pH and lactic acid failed to return to control value and lactate: pyruvate ratio increased more after re-infusion.
Sodium bicarbonate decreased after bleeding and returned to control value following re-infusion.
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