Prevention of myocardial depression in experimental hemorrhagic shock by pretreatment with hydrocortisone
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Summary
The left anterior descending or left circumflex coronary artery was cannulated in ten dogs. 4 mg/kg hydrocortisone were slowly infused and the cannula was withdrawn. The dogs were then subjected to hemorrhagic shock for 90 minutes followed by retransfusion. The contractile force (CF) and its first derivative (df/dt) were measured in the pretreated (infused) area and in a control (non-perfused) area of the left ventricle. During the shock period, CF and df/dt in the non-pretreated area showed a 50% reduction in comparsion to the pre-shock level, whereas the contractile force in the area that had been pretreated with hydrocortisone did not change when compared to the pre-shock period. This study shows that myocardial depression secondary to hemorrhagic shock can be effectively prevented by pretreatment with hydrocortisone.
Keywords
Public Health Coronary Artery Hydrocortisone Left Ventricle Hemorrhagic ShockVorbeugung myokardialer Leistungsminderung im hämorrhagischen Schock durch Vorbehandlung mit Hydrocortison
Zusammenfassung
Bei 10 Hunden wurde der Ramus interventricularis ant. oder der Ramus circumflexus der linken Koronararterie kanüliert. Nach langsamer Infusion von 4 mg/kg Hydrocortison und Entfernung der Kanüle wurden die Hunde für 90 Minuten einem hämorrhagischen Schock unterworfen, gefolgt von einer Würcktransfusion. Die kontraktile Kraft (CF) und deren erste Ableitung (df/dt) wurden sowohl in dem vorbehandelten Bereich als auch in einem Kontrollbereich des linken Ventrikels gemessen. Während der Periode des Schocks zeigte CF und df/dt im nicht vorbehandelten Myokardbezirk einen 50% igen Rückgang im Vergleich zu den Ausgangswerten vor Einsetzen des Schocks, während sich die Kontraktionskraft in dem mit Hydrocortison vorbehandelten Bereich gegenüber der Vorperiode nicht änderte. Die Studie zeigt, daß einer schockbedingten myokardialen Leistungsminderung durch Vorbehandlung mit Hydrocortison wirkungsvoll vorgebeugt werden kann.
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