Application of negative tissue interstitial pressure improves functional capillary density after hemorrhagic shock in the absence of volume resuscitation.
Application of negative tissue interstitial pressure improves functional capillary density after hemorrhagic shock in the absence of volume resuscitation.
复制标题
DOI：
10.14814/phy2.14783
复制
发表时间：
2021-03
影响因子：
2.5
通讯作者：
Cabrales P
中科院分区：
文献类型：
--
作者：
Jani VP;Jani VP;Munoz CJ;Govender K;Williams AT;Cabrales P
微血管液体交换主要取决于 Starling 力以及小动脉和毛细血管后微静脉的主动和被动生肌反应。小动脉通常被认为是阻力血管，而小静脉被认为是电容血管，在休息时具有高扩张性和低强直性交感神经刺激。然而，很少有研究调查调节间质静水压的影响，特别是在失血性休克的情况下。本研究的目的是研究 40% 总血容量失血性休克后应用负组织间质压期间的小动脉力学和功能性毛细血管密度 (FCD)。在这项研究中，我们通过活体显微镜表征了装有背窗室和定制设计的负压施加装置的仓鼠的全身和微循环血流动力学参数，包括 FCD。在大动脉中，失血性休克后应用负压导致流量减少 13·11%，而仅失血性休克 90 分钟后流量仅减少 7·9%。然而，在毛细血管后微静脉中，失血性休克后施加负压导致流量减少 31·4%，而单独失血性休克 90 分钟后流量仅减少 8·5%。与未施加负压的失血性休克（0.50±0.04）相比，失血性休克后施加负压后标准化 FCD 显着改善（0.66±0.02）。我们的研究表明，负压的应用可显着改善失血性休克期间的 FCD，尽管它不能使 FCD 正常化。这些结果表明，通过增加微脉管系统和间质之间的静水压梯度，可以在没有容量复苏的情况下暂时恢复微血管灌注。这项研究具有重要的临床意义，特别是在负压伤口治疗中，并提供了一种改善低血容量休克期间微血管灌注的替代机制。本研究的目的是研究 40% 总血容量失血性休克后应用负组织间质压期间的小动脉力学和功能性毛细血管密度 (FCD)。与未施加负压的失血性休克 (0.50 ± 0.04) 相比，失血性休克后施加负压后标准化 FCD 显着改善 (0.66 ± 0.02)。我们的研究表明，负压的应用可显着改善失血性休克期间的 FCD，尽管它不能使 FCD 正常化。
Microvascular fluid exchange is primarily dependent on Starling forces and both the active and passive myogenic response of arterioles and post‐capillary venules. Arterioles are classically considered resistance vessels, while venules are considered capacitance vessels with high distensibility and low tonic sympathetic stimulation at rest. However, few studies have investigated the effects of modulating interstitial hydrostatic pressure, particularly in the context of hemorrhagic shock. The objective of this study was to investigate the mechanics of arterioles and functional capillary density (FCD) during application of negative tissue interstitial pressure after 40% total blood volume hemorrhagic shock. In this study, we characterized systemic and microcirculatory hemodynamic parameters, including FCD, in hamsters instrumented with a dorsal window chamber and a custom‐designed negative pressure application device via intravital microscopy. In large arterioles, application of negative pressure after hemorrhagic shock resulted in a 13 11% decrease in flow compared with only a 7 9% decrease in flow after hemorrhagic shock alone after 90 minutes. In post‐capillary venules, however, application of negative pressure after hemorrhagic shock resulted in a 31 4% decrease in flow compared with only an 8 5% decrease in flow after hemorrhagic shock alone after 90 minutes. Normalized FCD was observed to significantly improve after application of negative pressure after hemorrhagic shock (0.66 0.02) compared to hemorrhagic shock without application of negative pressure (0.50 0.04). Our study demonstrates that application of negative pressure acutely improves FCD during hemorrhagic shock, though it does not normalize FCD. These results suggest that by increasing the hydrostatic pressure gradient between the microvasculature and interstitium, microvascular perfusion can be transiently restored in the absence of volume resuscitation. This study has significant clinical implications, particularly in negative pressure wound therapy, and offers an alternative mechanism to improve microvascular perfusion during hypovolemic shock. The objective of this study was to investigate the mechanics of arterioles and functional capillary density (FCD) during application of negative tissue interstitial pressure after 40% total blood volume hemorrhagic shock. Normalized FCD was observed to significantly improve after application of negative pressure after hemorrhagic shock (0.66 ± 0.02) compared to hemorrhagic shock without application of negative pressure (0.50 ± 0.04). Our study demonstrates that application of negative pressure acutely improves FCD during hemorrhagic shock, though it does not normalize FCD.
负压在严重的出血性休克期间增加微血管灌注。
影响因子：
3.1
作者：
Govender K;Munoz CJ;Williams AT;Cabrales P
通讯作者：
Cabrales P