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Am J Physiol Heart Circ Physiol 283: H2511-H2517, 2002. First published August 8, 2002; doi:10.1152/ajpheart.00222.2002
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Vol. 283, Issue 6, H2511-H2517, December 2002

Jejunal tissue oxygenation and microvascular flow motion during hemorrhage and resuscitation

Werner Pajk, Birgit Schwarz, Hans Knotzer, Barbara Friesenecker, Andreas Mayr, Martin Dünser, and Walter Hasibeder

Division of General and Surgical Intensive Care Medicine, Department of Anesthesia and Critical Care Medicine, The Leopold Franzens University of Innsbruck, A-6020 Innsbruck, Austria

The relationship between flow motion and tissue oxygenation was investigated during hemorrhage/retransfusion with and without dopamine in 14 pigs. During 45% bleed, jejunal microvascular hemoglobin O2 saturation (HBjO2) and mucosal tissue PO2 (PO2muc) were recorded in seven control and seven dopamine-treated animals. Mean arterial pressure and systemic O2 delivery decreased during hemorrhage and returned to baseline after retransfusion. Hemorrhage decreased PO2muc from 33 ± 2.8 to 13 ± 1.6 mmHg and HBjO2 from 53 ± 4.9% to 32 ± 3.9%, respectively, in control animals. During reperfusion, PO2muc and HBjO2 remained low. Dopamine increased PO2muc from 28 ± 4.3 to 45 ± 4.6 mmHg and HBjO2 from 54 ± 5.7% to 69 ± 1.5% and attenuated the decrease in PO2muc and HBjO2 during hemorrhage. After retransfusion, dopamine restored PO2muc and HBjO2 to baseline. Control animals developed rhythmic HBjO2 oscillations with increasing amplitude (frequency, 4.5 to 7.6 cycles/min) and showed an inverse relationship between PO2muc and HBjO2 oscillation amplitude. Dopamine prevented regular flow motion. The association between decreased PO2muc and increased oscillations in HBjO2 after normalization of systemic hemodynamics and O2 transport in control animals suggests a cause-and-effect relationship between low tissue PO2 and flow motion activity within the jejunal microcirculation.

hemorrhagic shock; vasomotion; dopamine; microcirculation; jejunum


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