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Titolo:
Mesenteric vasoconstriction in response to hemorrhagic shock
Autore:
Toung, T; Reilly, PM; Fuh, KC; Ferris, R; Bulkley, GB;
Indirizzi:
Johns Hopkins Univ, Sch Med, Dept Anesthesiol, Baltimore, MD 21287 USA Johns Hopkins Univ Baltimore MD USA 21287 hesiol, Baltimore, MD 21287 USA Johns Hopkins Univ, Sch Med, Dept Crit Care Med, Baltimore, MD 21287 USA Johns Hopkins Univ Baltimore MD USA 21287 re Med, Baltimore, MD 21287 USA Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD 21287 USA Johns Hopkins Univ Baltimore MD USA 21287 t Surg, Baltimore, MD 21287 USA
Titolo Testata:
SHOCK
fascicolo: 4, volume: 13, anno: 2000,
pagine: 267 - 273
SICI:
1073-2322(200004)13:4<267:MVIRTH>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIOGENIC-SHOCK; ARGININE-VASOPRESSIN; ANGIOTENSIN; ANTAGONISTS; ISCHEMIA; PIGS;
Keywords:
splanchnic circulation; mesenteric ischemia; renin; angiotensin; sympathetic nervous system; swine; vasopressin; splanchnic vasoconstriction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Bulkley, GB Johns Hopkins Hosp, Blalock 685,600 N Wolfe St, Baltimore, MD 21287 USA Johns Hopkins Hosp Blalock 685,600 N Wolfe St Baltimore MD USA 21287
Citazione:
T. Toung et al., "Mesenteric vasoconstriction in response to hemorrhagic shock", SHOCK, 13(4), 2000, pp. 267-273

Abstract

Previous studies indicate that cardiogenic shock (tamponade) in swine produces selective mesenteric ischemia due to disproportionate mesenteric vasospasm mediated primarily by the renin-angiotensin axis. Here, we characterized the systemic and mesenteric hemodynamic responses to hypovolemic shock to better understand the neurohumoral mechanisms controlling this response. Varying degrees of hypovolemic shock were produced by graded levels of hemorrhage, from 12.5 to 50% of the calculated blood volume. Systemic and mesenteric pressures and blood flows were measured, and corresponding vascular resistances were calculated. The hemodynamic responses of the mesenteric vascular bed were compared with those of the systemic (nonmesenteric) vasculature. These experiments were then repeated after confirmed blockade either of the or-adrenergic nervous system (phenoxybenzamine), of vasopressin (Manning compound), or of the renin-angiotensin axis (enalapril). Graded levels of hemorrhage produced corresponding graded, reproducible, steady-state levels of systemic hypotension, hypoperfusion, and peripheral vasoconstriction, i.e., hemorrhagio shock. This was associated with disproportionate degrees of mesenteric ischemia due to disproportionate mesenteric vasoconstriction. The selective component of this mesenteric vasoconstrictive response wasnot attenuated by al-adrenergic blockade nor by vasopressin blockade but was blocked by ablation of the renin-angiotensin axis with enalapril. Like cardiogenic shock, hemorrhagic shock generates selective mesenteric ischemiaby producing a disproportionate mesenteric vasospasm that is mediated primarily by the renin-angiotensin axis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 03:18:13