Effects of environmental hypothermia on hemodynamics and oxygen dynamics in a conscious swine model of hemorrhagic shock

doi:10.5847/wjem.j.issn.1920-8642.2012.02.009

Abstract

Abstract:

BACKGROUND: Hypothermia is associated with poor outcome in trauma patients; however, hemorrhagic shock (HS) model with anesthetized swine was different from that of clinical reality. To identify the effects of environmental hypothermia on HS, we investigated hemodynamics and oxygen dynamics in an unanesthetized swine model of HS under simulating hypothermia environment.

METHODS: Totally 16 Bama pigs were randomly divided into ambient temperature group (group A) and low temperature group (group B), 8 pigs in each group. Venous blood (30 mL/kg) was continuously withdrawn for more than 15 minutes in conscious swine to establish a hemorrhagic shock model. Pulmonary arterial temperature (Tp), heart rate (HR), mean arterial pressure (MAP), pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), central venous pressure (CVP), cardiac output (CO), hemoglobin (Hb), saturation of mixed venous blood (SvO₂) and blood gas analysis were recorded at the baseline and different hemorrhagic shock time (HST). The whole body oxygen delivery indices, DO₂I and VO₂I, and the O₂ extraction ratio (O₂ER) were calculated.

RESULTS: Core body temperature in group A decreased slightly after the hemorrhagic shock model was established, and environmental hypothermia decreased in core body temperature. The mortality rate was significantly higher in group B (50%) than in group A (0%). DO₂I and VO₂I decreased significantly after hemorrhage. No difference was found in hemodynamics, DO₂I and VO₂I between group A and group B, but the difference in pH, lactic acid and O₂ER was significant between the two groups.

CONCLUSION: Environmental hypothermia aggravated the disorder of oxygen metabolism after hemorrhagic shock, which was associated with poor prognosis.

Key words: Hemorrhagic shock, Environmental hypothermia, Hemodynamics, Oxygen dynamics

Cheng Zhang, Guang-rong Gao, Hui-yong Jiang, Chen-guang Lv, Bao-lei Zhang, Ming-shuang Xie, Zhi-li Zhang, Li Yu, Xue-feng Zhang. Effects of environmental hypothermia on hemodynamics and oxygen dynamics in a conscious swine model of hemorrhagic shock[J]. World Journal of Emergency Medicine, 2012, 3(2): 128-134.

Figures/Tables 6

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Variables	BL	HST 30min	HST 1h	HST 2h	HST 3h	HST 4h
PO₂(mmHg)
Group A	102±15	97±12	96±18	95±17	99±21	95±14
Group B	99±8	100±11	94±19	92±13	98±13	93±16
PCO₂(mmHg)
Group A	38±4.1	24±4.3	29±4.2	34±2.9	35±3.8	34±4.2
Group B	39±4.7	28±7.1	32±6.1	34±7.7	34±7.2	36±3.7
HR (beats/min)
Group A	99±23	166±15	160±26	146±31	125±33	130±26
Group B	103±19	174±39	161±34	155±17	146±27	155±15
DO₂I (mL/min?m²)
Group A	834±65	221±64	284±85	283±66	306±75	288±77
Group B	783±74	197±54	217±95	236±69	242±52	206±51
VO₂I (mL/min?m²)
Group A	347±76	160±37	185±39	176±36	170±44	167±56
Group B	299±71	146±32	137±27	172±51	186±33	152±36

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