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1 Department of Physiology and Pharmacology, 2 Department of Comparative Medicine, Oregon Health & Science University, Portland 97239; 3 Division of Cardiology, Department of Medicine, Portland Veterans Affairs Medical Center, Portland, Oregon 97207
Pregnant animals are less able to
maintain mean arterial pressure (MAP) during hemorrhage compared with
nonpregnant animals, but the hemodynamic basis of this difference is
unknown. The hypothesis that pregnancy attenuates responses of cardiac
output, as well as total peripheral resistance (TPR) and femoral
conductance, to hemorrhage was tested in conscious rabbits in both the
pregnant and nonpregnant state (n = 10). During
continuous slow blood loss (2% of the initial blood volume per
minute), MAP was maintained initially in both groups. However, MAP then
abruptly decreased to <45 mmHg in all animals after a smaller
percentage of the initial blood volume was removed in pregnant compared
with nonpregnant rabbits (43.6 ± 1.7%, nonpregnant; 29.6 ± 2.2%, pregnant; P < 0.005). The more rapid transition
to hypotension exhibited by pregnant rabbits was associated with
greater initial falls in cardiac output (
56 ± 10 ml/min,
nonpregnant;
216 ± 33 ml/min, pregnant; P < 0.005) and stroke volume (0.8 ± 0.1 ml/beat, nonpregnant;
1.3 ± 0.1 ml/beat, pregnant; P < 0.05). In
addition, the increase in TPR as a function of the decrease in cardiac
output was markedly attenuated (P < 0.0001) during
pregnancy. Whereas femoral conductance decreased in nonpregnant
rabbits, it did not change significantly in pregnant animals. In
conclusion, the lesser ability of conscious pregnant rabbits to
maintain MAP during hemorrhage is due largely to a greater decrease in
cardiac output but also to inadequate reflex increases in TPR, possibly
in part in the femoral vascular bed.
cardiac output; stroke volume; total peripheral resistance; mean arterial pressure; femoral conductance
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