Interstitial Metabolic Monitoring During Hemorrhagic Shock
Abstract
Decompensation in hemorrhagic shock is the critical stage after which resuscitative efforts may prove futile. We hypothesize that decompensation results from potassium-mediated vasodilation and/or loss of cardiac contractility, and thus a method of measuring interstitial potassium should be a crucial part of future metabolic monitoring efforts. Anesthetized rats underwent controlled hemorrhage to a constant mean arterial pressure of 40 mmllg. Microdialysis probes were implanted in skeletal muscle, vein, and liver for continuous assessment of potassium, glucose, lactate, pyruvate, and glycerol concentrations. Arterial blood samples were drawn at 30- minute intervals. Animals were sacrificed in early (pre-decompensatory) and late (decompensatory) hemorrhagic shock and tissues analyzed for ex vivo Na+,K+-ATPase activity. Potassium concentrations in muscle interstitium were significantly higher in hemorrhaged animals than controls (2.34 times baseline vs. 1.24, p < 0.05), this difference was not reflected in blood values. Na+,K+-ATPase activity in late hemorrhagic shock was increased vs. controls (p<0.05) in kidney, skeletal muscle, cardiac muscle, diaphragm, and red blood cells. ATPase activity was also increased in early hemorrhagic shock in skeletal and cardiac muscle. These data may provide clues into new ways to monitor and treat victims of hemorrhagic shock on the battlefield.
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 01, 2004
- Accession Number
- ADA423725
Entities
People
- Motilal B. Pamnani
Organizations
- Henry M. Jackson Foundation for the Advancement of Military Medicine