Miyamoto T, Shirahama M, Kiryu C, Mwanza T, Okumura M, Hagio M, Fujinaga T
Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan.
J Vet Med Sci. 1997 May;59(5):347-52. doi: 10.1292/jvms.59.347.
The aim of this study was to examine renal hemodynamics at the hypovolemic and recovery phases in two different hypovolemic shock models using Doppler ultrasonography, and to compare this with systemic hemodynamics. In experiment 1, the hypovolemic phase was induced in 6 mongrel dogs by removing arterial blood at 30 ml/kg for 60 min. In the recovery phase, this blood was reinfused at 30 ml/kg over 60 min. In experiment 2, hypovolemia was induced in 12 beagle dogs by rapid blood removal until blood pressure decreased to 40 mmHg and was maintained at this pressure for 30 min. Six of the dogs were then infused with 20 ml/kg hydroxyethyl starch over 5 min, and the other 6 were infused with 60 ml/kg lactated Ringer's solution also over 5 min. Parameters for systemic and renal hemodynamics were measured by using a polygraph and the Doppler method, respectively. The decrease of diastolic blood flow, resulted in an increase of vessel resistance, and was detected in the hypovolemic kidney by the Doppler method. The rapid and large volume infusion of resuscitation fluids was effective for the recovery of both systemic circulation and renal blood flow, however this induced an increase of kidney vessel resistance, a result of the autoregulation mechanism of the kidney. The changes in these parameters at the main renal artery and interlobar artery were similar.
本研究的目的是使用多普勒超声检查在两种不同的低血容量性休克模型中检测低血容量期和恢复期的肾脏血流动力学,并将其与全身血流动力学进行比较。在实验1中,通过以30 ml/kg的剂量抽取动脉血60分钟,诱导6只杂种犬进入低血容量期。在恢复期,将这些血液在60分钟内以30 ml/kg的剂量回输。在实验2中,通过快速放血诱导12只比格犬出现低血容量,直至血压降至40 mmHg,并在此压力下维持30分钟。然后,其中6只犬在5分钟内输注20 ml/kg羟乙基淀粉,另外6只犬在5分钟内输注60 ml/kg乳酸林格氏液。分别使用多道生理记录仪和多普勒方法测量全身和肾脏血流动力学参数。通过多普勒方法在低血容量的肾脏中检测到舒张期血流减少,导致血管阻力增加。快速大量输注复苏液对全身循环和肾血流的恢复有效,然而这会导致肾血管阻力增加,这是肾脏自身调节机制的结果。在肾主动脉和叶间动脉处这些参数的变化相似。