• Meng Wang, Rabea Verhaegh, Konstantinos Tsagakis, Lisa Brencher, Denise Zwanziger, Heinz G Jakob, Groot Herbert de H Institute of Physiological Chemistry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., and Daniel-Sebastian Dohle.
• Department of Thoracic and Cardiovascular Surgery, West German Heart Center Essen, University Hospital, Duisburg-Essen University, Essen, Germany.
• Thorac Cardiovasc Surg. 2018 Jan 1; 66 (1): 99-108.

BackgroundAcute mesenteric ischemia following cardiovascular surgery is a rare but fatal complication. We established a new rat model for hemodynamic monitoring during mesenteric ischemia/reperfusion (I/R) and evaluated the impact of mesenteric I/R on hemodynamics and remote organ injury.MethodsMesenteric I/R was induced in male Wistar rats by superior mesenteric artery occlusion for 90 minutes, followed by 120 minutes of reperfusion. Before I/R, ventilation and hemodynamic monitoring including mean arterial blood pressure (MAP) and cardiac output (CO) were established. During reperfusion Geloplasma (I/R + Geloplasma, N = 6) and Ringer's solution (I/R + Ringer, N = 6) were titrated according to CO and compared with I/R without volume resuscitation (I/R only, N = 6) and a sham group (sham, N = 6). Blood samples were regularly taken for serum marker measurements. After reperfusion organs were harvested for histology studies.ResultsAfter acute mesenteric I/R, MAP and CO decreased (p < 0.01) while systemic and pulmonary vascular resistance increased (p < 0.01) continuously in the I/R group. Volume substitution according to CO initially stabilized hemodynamic parameters, but CO declined independently in the late stage. Compared with the I/R + Ringer group, the I/R + Geloplasma group required less volume for resuscitation (p < 0.01), experienced less metabolic acidosis. I/R groups had more organ injuries, more neutrophils sequestration, and higher creatine phosphokinase-MB levels than sham group.ConclusionA new model for CO monitoring after mesenteric I/R injury demonstrated severe hypovolemic shock during reperfusion followed by remote myocardial and lung injury. Far less colloid volume is needed for hemodynamic stabilization after I/R compared with crystalloid volume.Georg Thieme Verlag KG Stuttgart · New York.

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