Negative pressure increases microvascular perfusion during severe hemorrhagic shock.
Negative pressure increases microvascular perfusion during severe hemorrhagic shock.
复制标题
负压在严重的出血性休克期间增加微血管灌注。
DOI：
10.1016/j.mvr.2020.104125
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发表时间：
2021-03
影响因子：
3.1
通讯作者：
Cabrales P
中科院分区：
文献类型：
--
作者：
Govender K;Munoz CJ;Williams AT;Cabrales P
出血性休克（HS）是一种严重的危及生命的疾病，其特征是血容量损失和组织缺氧（O2）。本研究的目的是检查在HS期间操纵微循环中的Starling力以增加微血管灌注而不恢复血容量或增加O2携带能力的影响。为了降低间质组织压力，我们开发了一种非接触式系统，用于局部施加负压并操纵毛细血管中的压力平衡，同时允许微循环的可视化。金黄色叙利亚仓鼠装备有背侧窗室，并在没有任何液体复苏的情况下进行动物血容量50%的受控复苏。将负压室连接到背窗室并施加恒定的负压。在出血前和出血后4小时内，在施加和不施加负压的情况下测量血液动力学参数（包括微血管直径、血流量和功能性毛细血管密度[FCD]）。在负压期间，小动脉的血流量显著增加。通过小动脉的流量的增加也改善了微血管灌注，如FCD增加所反映的。这些结果表明，当液体复苏不可用时，负压增加了微循环中的流量，从而恢复了血流、氧气输送，并防止了代谢废物的积累。施加负压可能允许控制微血管血流和向特定组织区域输送氧气。
Hemorrhagic shock (HS) is a severe life-threatening condition characterized by loss of blood volume and a lack of oxygen (O2) delivery to tissues. The objective of this study was to examine the impact of manipulating Starling forces in the microcirculation during HS to increase microvascular perfusion without restoring blood volume or increasing O2 carrying capacity. To decrease interstitial tissue pressure, we developed a non-contact system to locally apply negative pressure and manipulate the pressure balance in capillaries, while allowing for visualization of the microcirculation. Golden Syrian hamsters were instrumented with dorsal window chambers and subjected to a controlled hemorrhaged of 50% of the animal’s blood volume without any fluid resuscitation. A negative pressure chamber was attached to the dorsal window chamber and a constant negative pressure was applied. Hemodynamic parameters (including microvascular diameter, blood flow, and functional capillary density [FCD]) were measured before and during the four hours following the hemorrhage, with and without applied negative pressure. Blood flow significantly increased in arterioles during negative pressure. The increase in flow through arterioles also improved microvascular perfusion as reflected by increased FCD. These results indicate that negative pressure increases flow in the microcirculation when fluid resuscitation is not available, thus restoring blood flow, oxygen delivery, and preventing the accumulation of metabolic waste. Applying negative pressure might allow for control of microvascular blood flow and oxygen delivery to specific tissue areas.
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DOI：
10.1016/b978-0-12-394309-5.00006-7
发表时间：
2012
影响因子：
--
作者：
Kalogeris, Theodore;Baines, Christopher P.;Krenz, Maike;Korthuis, Ronald J.
通讯作者：
Korthuis, Ronald J.
DOI：
10.1159/000179088
发表时间：
1995-01-01
期刊：
INTERNATIONAL JOURNAL OF MICROCIRCULATION-CLINICAL AND EXPERIMENTAL
影响因子：
--
作者：
Nolte, D;Menger, MD;Messmer, K
通讯作者：
Messmer, K
影响因子：
3.3
作者：
Watkins, William;Hargens, Alan R.;Macias, Brandon R.
通讯作者：
Macias, Brandon R.
影响因子：
8.8
作者：
Tachon, Guillaume;Harrois, Anatole;Duranteau, Jacques
通讯作者：
Duranteau, Jacques
DOI：
10.1007/bf01851841
发表时间：
1980-01-01
期刊：
RESEARCH IN EXPERIMENTAL MEDICINE
影响因子：
--
作者：
ENDRICH, B;ASAISHI, K;MESSMER, K
通讯作者：
MESSMER, K