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Effects of viscogenic plasma expander on cardiac and vascular function.

机译:内源性血浆扩张剂对心脏和血管功能的影响。

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摘要

Lowering the amount of red blood cells (RBCs) caused by blood losses or anemia leads to the reduction of tissue oxygenation and anaerobic metabolism, ultimately inducing multi-organ dysfunction. Plasma expanders (PEs) and blood are used sequentially to treat volume deficit. Recently, the systemic and microscopic recovery has been proposed to be related to the restoration of the viscosity of circulating blood to values prevailing during normovolemic conditions. Studies in an awake hamster window chamber showed that the viscosity of PE plays a role in microvascular function. High viscosity PEs (HVPEs) have been tested in conditions of hemorrhagic shock resuscitation and acute hemodilution, supporting the contention that the restoration of blood viscosity to normal value is beneficial in studies made in awake animals. Recent studies, in awake animals, have shown that polyethylene glycol conjugated to human serum albumin (PEG-HSA) can achieve the similar results caused by HVPEs. However, the effects of increasing plasma viscosity on the heart performance are insufficiently explored.;The hypothesis of this study was that cardiac and vascular function is enhanced when plasma viscosity is increased even though the amount of RBCs decreases. Hemorrhagic shock resuscitation and acute hemodilution protocols were performed to test this hypothesis. Cardiac function was assessed in the left ventricle with a pressurevolume conductance catheter. As the modulation of plasma viscosity, the effects of shear stress-induced vasodilator, nitric oxide (NO), on cardiac function was examined. Furthermore, the effect of interaction of PE with endothelial glycocalyx on cardiac function was investigated.;The results showed that HVPE and PEG-HSA demonstrated the beneficial effects on cardiac function in acute hemodilution by increased cardiac output, lowered systemic vascular resistance and sustained cardiac contractility. However, HVPE did not show any enhancement on cardiac function in hemorrhagic shock resuscitation. There was a contribution of increased NO to the beneficial effects on cardiac function as observed in the acute hemodilution with low viscosity PE. It also revealed that PEG-HSA and HVPE interacted with endothelial glycocalyx with different mechanism but they showed similar results in cardiac function, implying an important role of endothelial glycocalyx in cardiac and vascular function.
机译:由失血或贫血引起的红细胞(RBC)数量减少导致组织氧合和无氧代谢减少,最终导致多器官功能障碍。血浆扩张剂(PEs)和血液顺序用于治疗容量不足。近来,已提出全身和微观恢复与将循环血液的粘度恢复至在正常血流病期间普遍存在的值有关。在清醒的仓鼠窗室中进行的研究表明,PE的粘度在微血管功能中起作用。已经在失血性休克复苏和急性血液稀释的条件下对高粘度PE(HVPE)进行了测试,这支持了将血液粘度恢复至正常值对清醒动物研究有益的观点。最近在清醒的动物中进行的研究表明,与人血清白蛋白(PEG-HSA)偶联的聚乙二醇可以达到由HVPE引起的类似结果。然而,尚未充分探讨增加血浆粘度对心脏性能的影响。本研究的假设是,即使RBCs减少,血浆粘度增加时,心脏和血管功能也会增强。进行了失血性休克复苏和急性血液稀释方案以检验这一假设。使用压力容量传导导管评估左心室的心脏功能。作为血浆粘度的调节,研究了剪切应力诱导的血管扩张剂一氧化氮(NO)对心脏功能的影响。此外,研究了PE与内皮糖萼相互作用对心脏功能的影响。结果表明,HVPE和PEG-HSA通过增加心输出量,降低全身血管阻力和持续的心脏收缩力,显示出对急性血液稀释中心脏功能的有益作用。 。但是,HVPE在失血性休克复苏中并未显示出心脏功能的任何增强。如在低粘度PE的急性血液稀释中观察到的,NO的增加对心脏功能的有益影响。研究还表明,PEG-HSA和HVPE与内皮糖萼的相互作用机理不同,但它们在心脏功能方面表现出相似的结果,这暗示着内皮糖萼在心脏和血管功能中的重要作用。

著录项

  • 作者

    Chatpun, Surapong.;

  • 作者单位

    University of California, San Diego.;

  • 授予单位 University of California, San Diego.;
  • 学科 Engineering Biomedical.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 195 p.
  • 总页数 195
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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