• Title/Summary/Keyword: hemorrhagic shock

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The Effects of Urinary Trypsin Inhibitor on Hemorrhagic Shock (오줌 유래 Trypsin 억제제가 출혈성쇼크에 미치는 영향)

  • 권오경;김종민;이희천;정언승;양한석;변종환;송동호;조명행
    • Biomolecules & Therapeutics
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    • v.5 no.3
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    • pp.223-227
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    • 1997
  • The protective effect of human urinary trypsin inhibitor(UTI) on acute hemorrhagic shock in beagle dog was studied. Hemorrhagic shock was experimentally induced in thoracotomized beagle dogs by removing blood and maintaining low arterial blood pressure for 30 min, and then blood removed was entirely transfused back into the dogs within one hour. When the blood was transfused, UTI was administered together to check the potential protective effect of UTI on hemorrhagic shock. The arterial blood pressure recovery was accelerated slightly by UTI treatment. Blood pH and $P_{a co2}$ returned to normal level in shorter time in the UTI treatment group. These data suggest that UTI may have protective effects on experimentally induced hemorrhagic shock.

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A Study for Changes of Blood Pressure and Heart Rate by Acupressure to Acupoints in Rat Model of Hemorrhagic Shock (출혈성 쇼크 흰쥐 모델에서 경혈 지압이 혈압과 심박수 변화에 미치는 영향)

  • Yang, Seung-Bum;Byun, Sin-Kyu;Kim, Jae-Hyo
    • Korean Journal of Acupuncture
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    • v.33 no.2
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    • pp.58-66
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    • 2016
  • Objectives : In order to find a possible non-invasive manipulation tool for maintenance of the cardiovascular functions in hemorrhagic shock, this study was aimed at evaluating effects of acupoints acupressure on the changes in blood pressure and heart rate from an animal model of hemorrhagic shock. Methods : In adult Sprague-Dawley rats, hemorrhagic shock was induced by a withdrawal of arterial blood from the femoral artery with volume of 0.8 ml per 100 g of body weight using peristaltic syringe pump. We applied the acupressure with a pressure oscillator to tail as a control and 2 different acupoints of sobu(HT8), youngchun(KI1) under 3 different conditions : 1) normal arterial blood pressure without bleeding, 2) at the beginning of bleeding, and finally 3) hemorrhagic shock. Results : Under normal arterial blood pressure without hemorrhage, there was a significant increase in systolic and diastolic blood pressures by the acupressure to the tail, HT8 and especially KI1 for 30 sec compared with before acupressure. Under hemorrhagic shock condition, the tail acupressure had minimal changes in cardiovascular parameters. Either the HT8 or KI1 acupressure resulted in a significant increase in arterial pressure but did not heart rate. At the beginning of bleeding, tail acupressure failed to change the reduction of arterial pressure and heart rate. However, there was a significant increase in blood pressure and heart rate following either the HT8 or especially KI1 acupressure. Conclusions : HT8 and KI1 acupressure affected cardiovascular signs but tail acupressure did not in rat model of hemorrhagic shock. These experimental data suggest that a acupressure with a pressure oscillator to HT8 or KI1 can be one of alternative emergency manipulations to ameliorate compromised cardiovascular functions under hemorrhagic shock condition.

A survival prediction model of hemorrhagic shock in rats using a logistic regression equation (출혈성 쇼크를 일으킨 흰쥐에서 로지스틱 회귀분석을 이용한 생존율 예측)

  • Lee, Tak-Hyung;Lee, Ju-Hyung;Chung, Sang-Won;Kim, Deok-Won
    • Proceedings of the IEEK Conference
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    • 2009.05a
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    • pp.132-134
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    • 2009
  • Hemorrhagic shock is a common cause of death in emergency rooms. Since the symptoms of hemorrhagic shock occur after shock has considerably progressed, it is difficult to diagnose shock early. The purpose of this study was to improve early diagnosis of hemorrhagic shock using a survival prediction model in rats. We measured ECG, blood pressure, respiration and temperature in 45 Sprague-Dawley rats, and then obtained a logistic regression equation predicting survival rates. Area under the ROC curves was 0.99. The Hosmer-Lemeshow goodness-of-fit chi-square was 0.86(degree of freedom=8, p=0.999). Applying the determined optimal boundary value of 0.25, the accuracy of survival prediction was 94.7%

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Preliminary study on physiological changes of hemorrhagic shock in rats (백서에서의 출혈성 쇼크로 인한 생리 변화에 관한 예비 연구)

  • Lee, Ju-Hyung;Kim, Soo-Chan;Lee, Tak-Hyung;Chung, Sang-Won;Kim, Deok-Won
    • Proceedings of the IEEK Conference
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    • 2008.06a
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    • pp.1075-1076
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    • 2008
  • Hemorrhagic shock is a common cause of death in emergency rooms. The objective evaluation of hemorrhagic shock is very important for early diagnosis and treatment. The purpose of this study is to understand its mechanism by analyzing the changes of bio-signals in hemorrhagic shock using controlled hemorrhage of SD rats. In this study, we constructed a hemorrhagic integrated system to control bleeding and to simultaneously measure bio-signals such as ECG, blood pressure, temperature, and respiration. In order to verify the system, we measured the bio-signals mentioned above while hemorrhagic shock was induced by withdrawing blood (2.5ml/100g/15min) from a femoral vein for 10 rats.

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Effect of Therapeutic Hypercapnia on Systemic Inflammatory Responses in Hemorrhagic Shock in Rats (랫드의 출혈성 쇼크 모델에서 치료적 고탄산혈증이 전신적 염증 반응에 미치는 영향)

  • Kang, Kyeong Won;Jo, You Hwan;Kim, Kyuseok;Lee, Jae Hyuk;Rhee, Joong Eui
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.17-24
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    • 2012
  • Purpose: This study was performed to investigate whether therapeutic hypercapnia could attenuate systemic inflammatory responses in hemorrhagic shock in rats. Methods: Male Sprague-Dawley rats were mechanically ventilated and underwent pressure-controlled (mean arterial pressure: $38{\pm}1$ mmHg) hemorrhagic shock. At 10 minutes after the induction of hemorrhagic shock, the rats were divided into the normocapnia ($PaCO_2$=35-45 mmHg, n=10) and the hypercapnia ($PaCO_2$=60-70 mmHg) groups. The $PaCO_2$ concentration was adjusted by using the concentration of inhaled $CO_2$ gas. After 90 minutes of hemorrhagic shock, rats were resuscitated with shed blood for 10 minutes and were observed for 2 hours. The mean arterial pressure (MAP) and the heart rate were monitored continuously, and the results of arterial blood gas analyses, as well as the plasma concentrations of interleukin (IL)-6, IL-10, and nitrite/nitrate were compared between the normocapnia and the hypercapnia groups. Results: The MAP and the heart rate were not different between the two groups. The plasma concentration of IL-6 was significantly lower in the hypercapnia group than in the normocapnia group (p<0.05). The IL-10 concentration was not different and the IL-6 to IL-10 ratio was significantly lower in the hypercapnia group compared to the normocapnia group. The plasma nitrite/nitrate concentration of the hypercapnia group was lower than that of the normocapnia group. Conclusion: Therapeutic hypercapnia attenuates systemic inflammatory responses in hemorrhagic shock.

Comparison of the trometamol-balanced solution with two other crystalloid solutions for fluid resuscitation of a rat hemorrhagic model

  • Ting, Wen-Ting;Chang, Ru-Wen;Wang, Chih-Hsien;Chen, Yih-Sharng;Lee, Jih-Jong
    • Journal of Veterinary Science
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    • v.21 no.1
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    • pp.6.1-6.12
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    • 2020
  • Currently, the optimal resuscitation fluid remains debatable. Therefore, in the present study, we designed a trometamol-balanced solution (TBS) for use as a resuscitation fluid for hemorrhagic shock. Hemorrhagic shock was induced in 18 male Wistar-Kyoto rats, which were assigned to normal saline (NS), Ringer's solution (RS), and TBS groups. During the hemorrhagic state, their hemodynamic parameters were recorded using an Abbott i-STAT analyzer with the CG4+ cartridge (for pH, pressure of carbon dioxide, pressure of oxygen, total carbon dioxide, bicarbonate, base excess, oxygen saturation, and lactate), the CG6+ cartridge (for sodium, potassium, chloride, blood glucose, blood urea nitrogen, hematocrit, and hemoglobin), and enzyme-linked immunosorbent assay kits (calcium, magnesium, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, and albumin). Similar trends were found for the parameters of biochemistries, electrolytes, and blood gas, and they revealed no significant changes after blood withdrawal-induced hemorrhagic shock. However, the TBS group showed more effective ability to correct metabolic acidosis than the NS and RS groups. TBS was a feasible and safe resuscitation solution in this study and may be an alternative to NS and RS for resuscitation in hemorrhagic shock patients without liver damage.

A New Shock Index for Predicting Survival of Rats with Hemorrhagic Shock Using Perfusion and Lactate Concentration Ratio (흰쥐의 출혈성 쇼크에서 관류와 젖산 농도 비를 이용한 새로운 생존 예측 지표 개발)

  • Choi, Jae-Lim;Nam, Ki-Chang;Kwon, Min-Kyung;Jang, Kyung-Hwan;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.48 no.4
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    • pp.1-9
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    • 2011
  • Hemorrhagic shock is a clinically widespread syndrome characterized by inadequate oxygenation and supply. It is important to diagnose hemorrhagic shock in its early stage for improving treatment effects and survival rate. However, an accurate diagnosis and treatment could be delayed in the early stage of hemorrhagic shock by evaluating only vital signs such as heart rate and blood pressure. There have been many studies for the early diagnosis of hemorrhagic shock, reporting that lactate concentration and perfusion were useful variables for tissue hypoxia and metabolic acidosis. In this study, we measured both perfusion using a laser Doppler flowmeter and lactate concentration from the volume controlled hemorrhagic shock using rats. We also proposed a new shock index which was calculated by dividing lactate concentration by perfusion for early diagnosis. As a result of the survival prediction by the proposed index with the receiver operating characteristic curve method, the sensitivity, specificity, and accuracy of survival were 90.0, 96.7 and 94.0%, respectively. The proposed index showed the fastest significant difference among the other parameters such as blood pressure and heart rate. It could offer early diagnosis and effective treatment for human hemorrhagic shock if it is applicable to humans.

Experimental study on the changes of serum free fatty acid and blood sugar during hemorrhagic shock (출혈성(出血性) Shock 에 출현(出現)되는 유리지방산(遊離脂肪酸) 및 혈당량(血糖量)의 변동(變動)에 관(關)하여)

  • Kim, Hyong-Se
    • The Korean Journal of Pharmacology
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    • v.2 no.1 s.2
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    • pp.99-109
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    • 1966
  • It has been known that the pronounced hypotension resulting from hemorrhage gives rise to compensatory stimulation of the adrenosympathetic system, which leads to an increase of liberation of catecholamines from sympathetic nervous system and adrenal medulla. It is obvious, therefore, that numerous physiological and biochemical changes during the hemorrhagic hypotention might be mediated through the increased liberation of catecholamines. Although an extensive studies have been reported on changes of protein and carbohydrate metabolism in hemorrhagic shock a few studies on the changes of lipid metabolism have been reported. Levenson(1961) observed a marked increase of serum lipids content during hemorrhagic shock and also noticed a marked elevation of serum free fatty acids. He suggested that these effects were due to mobilization and accelerated metabolic breakdown of lipids which might be resulted by sympathetic stimulation as a cause. To elucidate the mechanism of this, author studied the change of serum free fatty acids and blood sugar with relation to catecholamines during experimentally induced hemorrhagic shock in dog. Healthy male mongrel dogs weighing approximately 15kg were used. Under the general anesthesia with pentobarbital, rapid hemorrhage was produced from the femoral artery maintaining blood pressure level of 40 mmHg measured by the manometer connected with the opposite femoral artery throughout the experiment. Serum free fatty acids(FFA) and blood sugar were measured by the methods of Dole(1956) and Folin-wu,(1920) respectively. Tissue catecholamine was measured by Shore and Olin method(1958) using Aminco-Bowman spectrophotofluorometer.

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Changes in Water and Electrolyte Distribution and Blood Glucose Concentration following Irreversible Hemorrhagic Shock (비가역성 실혈성 쇽에서 본 가토심근, 혈장의 전해질 및 혈당량 변화)

  • Kim, Ki-Whan;Nam, Kee-Yong
    • The Korean Journal of Physiology
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    • v.2 no.1
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    • pp.47-52
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    • 1968
  • Twenty white rabbits anesthetized with nembutal (30 mg/kg) were employed in this experiment. Five of them served as controls; the remaining rabbits as experimental group were subjected to irreversible hemorrhagic shock. Shock was induced by bleeding the animals until mean blood pressure decreased to a level of 50-40 mmHg. This level of pressure was maintained for 3-4 hours, after which the drawn blood was reinfused. The reinfusion of blood caused the elevation of arterial pressure almost the control level for some minutes, after which a gradual and progressive decline of blood pressure became evident. This decline was thought to be the result from irreversible hemorrhagic shock. When mean blood pressure declined to less than 50 mmHg, chest was opened and samples of arterial blood and left ventricular muscle were taken. Left ventricular muscle and blood plasma were analyzed for potassium, sodium, chloride and water content. Blood glucose concentration was determined by Somogyi-Nelson's method. Extracellular and intracellular myocardial water and electrolyte content were calculated on the basis that electrolytes are distributed between plasma water and interstitial water according to Gibbs-Donnan equilibrium. In this calculation extracellular water was substituted for Na space. The findings obtained were as follows: 1. The concentration of blood glucose was 87mg% in the controls and it rose to 222 mg% in shock (P<0.01). 2. Plasma potassium elevated significantly from 3.3 mEq/l in controls to 8.0 mEq/l in shock (P<0.01), while small decreases in sodium (151-146 mEq/l) and chloride (102-96 mEq/l) were observed (P<0.3, P<0.1), 3. The changes of blood water content (83.1-84.3%) and cardiac water content (77.5-78.3 gm/100gm WT) were observed. 4. In control animals myocardial potassium levels which averaged 30.2 mEq/100 gmDT rose significantly to 40.3 mEq/100 gmDT in shock (P<0.01), while moderate decreases in sodium(16.3-14.3 mEq/100 gmDT) were observed in shock. 5. The calculated transmembrane resting potential of left ventricular muscle of control animals averaged 95 mV, while rabbits in shock averaged 77 mV. (P <0.01). The findings of this experiment do not correspond with the conclusions that myocardial depression seems to be the cause of irreversible hemorrhagic shock, because the excitability of heart muscle is elevated. From the point of view that the lowered transmembrane resting potential, the cause of death in terminal stage of irreversible hemorrhagic shock may be ventricular fibrillation. It can't be said, however, that the lowered transmembrane resting potential is responsible for the transition from reversible to irreversible hemorrhagic shock. The marked increase in blood glucose suggested that glycogenolysis in the liver is favorably active in shock.

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Non-occlusive Mesenteric Ischemia (NOMI) Secondary to Traumatic Hemorrhagic Shock: Case Report (외상성 출혈성 쇼크 환자에서 발생한 비 폐쇄성 장간막 허혈)

  • Lim, Kyoung Hoon;Jung, Hee Kyung;Cho, Jayun;Lee, Sang Cjeol;Park, Jinyoung
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.204-207
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    • 2014
  • Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow-up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation.