Circulatory shock
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The behavior of white blood cells (WBCs) in the capillary network of the cat brain was studied under normal conditions and during acute hemorrhagic hypotension. A small transilluminated area of the cerebral cortex was observed directly, and blood cells flowing through the capillary network were recorded on cinefilm using a high-speed cinecamera. The cell motion was analyzed on the projection screen using a frame-by-frame method. ⋯ RBC velocity in capillaries was reduced. The ST level was increased significantly with a decrease in RBC velocity. These findings suggest that acute hemorrhagic hypotension may induce flow maldistribution in cerebral microcirculation.
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Hypertonic saline (ie, 7.5% NaCl) was injected intravenously (4 ml/kg bolus) to determine its effects in feline and murine models of hemorrhagic shock. Hypertonic NaCl transiently improved mean arterial blood pressure (MABP), superior mesenteric artery blood flow (SMAF), and cardiac output (CO) during the oligemic period. These effects lasted from 15 to 75 min. ⋯ Nevertheless, the plasma activity of a myocardial depressant factor (MDF) was significantly lower in shock cats and rats given hypertonic saline compared with the 0.9% NaCl groups (31 +/- 4 vs 54 +/- 7 U/ml, p less than 0.02, in cats; and 27 +/- 2 vs 51 +/- 7 U/ml, p less than 0.02, in rats). The beneficial effects of small-volume resuscitation with 7.5% NaCl during hemorrhagic shock in cats and rats are likely due to the transient hemodynamic improvement during the oligemic period rather than sustained improvement in splanchnic perfusion or in prevention of cellular injury during shock. Our results in two species (eg, cat and rat) suggest that small-volume resuscitation with 7.5% NaCl may be a useful initial treatment of hemorrhagic shock when supplemented by subsequent blood transfusion or perhaps some other appropriate pharmacologic intervention.