Splenic Effects on Hemodynamics Induced by Hypothermia and Rewarming in MiniatureSwine

摘要

Central arterial hemodynamic changes were assessed during cooling, hypothermia,and rewarming in splenectomized (SPX, n = 4) and unsplenectomized (SP, n = 4) 8-10 month old male Yucatan miniature swine (34.0 % 1.4 kg). Under isoflurane anesthesia, and using circulating-water blankets, pigs were cooled to and then maintained for 2 h at a rectal temperature (Tre) of 27 % 1 deg C; hypothermia was followed by rewarming to normothermia (37 % 1 deg C). There were significantly (p % 0.05) greater changes in central arterial hematocrit and hemoglobin (AHCT and AHGB) from respective precooling baseline levels in the SP group during hypothermia and early rewarming (SP: AHCTmox = 10%RBC, and HGBmcx = 3.0-3.5 g/dl vs. SPX: HCTmax = 3-4%RBC, and HGBmax = 1.5-1.8 g/dl). By the end of rewarming, splenic resequestration and extravascular fluid shifts resulted in these values returning to baseline. In addition, cardiovascular instability was seen in the SPX group compared to the SP animals as evidenced by significant tachycardia and hypotension during rewarming. We have concluded from these studies that hypothermia causes significant hemoconcentration, and that splenic contraction is the major cause of this hemoconcentration during hypothermia and initial rewarming in miniature swine. A splenectomized design should be considered for swine studies that purport to pattern human pathophysiology, especially for modelling rewarming shock. pg1. JMD.