Section of Vascular Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
J Endovasc Ther. 2011 Aug;18(4):491-6. doi: 10.1583/10-3374.1.
To investigate the thoracic aortic pulsatility during hypovolemic shock in an experimental porcine model.
The circulating blood volume of 7 healthy Yorkshire pigs was gradually lowered until the subjects had lost 40% of their normal blood volume. Intravascular ultrasound was used to assess the aortic pulsatility in normovolemic and hypovolemic state at the level of the ascending and descending thoracic aorta.
The mean aortic pulsatility at the level of the ascending aorta decreased from 15.9% ± 7.2% (range 6.3%-25.7%) in normovolemia to 6.2% ± 2.8% (range 2.9%-10.7%, p = 0.018) in hypovolemia. At the level of the descending thoracic aorta, the mean aortic pulsatility decreased from 8.7% ± 2.8% (range 4.4%-12.2%) at baseline to 5.6% ± 2.5% (range 1.5%-9.5%, p = 0.028) in hypovolemia. The maximum mean aortic diameter, obtained in cardiac systole, was significantly smaller as well at both evaluated levels during hypovolemic shock compared with the mean diameter in normovolemia.
The thoracic aortic diameter and pulsatility decreased significantly during hypovolemic shock in this porcine model, most impressively at the level of the ascending aorta. Electrocardiographically-gated imaging may not be necessary for hypovolemic patients with acute aortic disease requiring endovascular repair because of the minimal aortic pulsatility.
在实验性猪模型中研究低血容量性休克时的胸主动脉搏动性。
逐渐降低 7 头健康约克夏猪的循环血量，直到受检者失去正常血量的 40%。血管内超声用于评估升主动脉和降主动脉水平的正常血容量和低血容量状态下的主动脉搏动性。
升主动脉水平的平均主动脉搏动性从正常血容量时的 15.9%±7.2%（范围 6.3%-25.7%）降至低血容量时的 6.2%±2.8%（范围 2.9%-10.7%，p=0.018）。在降主动脉水平，平均主动脉搏动性从基线时的 8.7%±2.8%（范围 4.4%-12.2%）降至低血容量时的 5.6%±2.5%（范围 1.5%-9.5%，p=0.028）。在低血容量性休克期间，两个评估水平的最大平均主动脉直径（在心脏收缩期获得）也明显小于正常血容量时的平均直径。
在这种猪模型中，低血容量性休克时胸主动脉直径和搏动性明显下降，在升主动脉水平最为显著。对于需要血管内修复的急性主动脉疾病且血容量不足的患者，由于主动脉搏动性极小，可能不需要心电图门控成像。
