Advertisement

Critical Oxygen Delivery Levels during Shock Following Normoxic and Hyperoxic Haemodilution with Fluorocarbons or Dextran

  • N. S. Faithfull
  • S. M. Cain
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 215)

Summary

Fluosol-DA 20% (FDA), an emulsion of fluorocarbons in a glucose electrolyte solution can deliver physiologically significant amounts of oxygen (O2) to the tissues and improve ischaemic hypoxia. To investigate its effect on critical oxygen delivery level (QO2c), four groups of six phenobarbitone anaesthetised air-ventilated splenic clamped mongrel dogs were haemodiluted to a haematocrit (Hct) of 25%; two groups with FDA and two with 6% dextran solution. Oxygen consumption (VO2) was derived from expired gas measurement and analysis, or by using a spirometer and carbon dioxide absorption. Whole body O2 flux (QO2) was calculated from mixed venous and arterial O2 contents and the Fick-derived cardiac output. QO2 was progressively decreased by haemorrhaging in steps of 1.5–2.5 ml per kg. Hct was kept at 25% using packed cells. VO2/QO2 pairs were calculated at each step and QO2c was determined for each animal by least squares fitting of data with 2 straight lines. Analyses of variance were performed.

QO2c was significantly less in the FDA and O2 (F+O) group than either the dextran and O2 (D+O) or dextran and air (D+A) groups. Analysis of O2 extraction at QO2c, which effectively normalized results for differences in resting VO2, had significantly better extraction in the FDA and air (F+A) than the D+A group. When fluorocarbon- and plasma-dissolved oxygen was subtracted, the O2 extraction in the F+A group was significantly better than in the D+A and F+O groups. The results imply that normoxic FDA haemodilution in animals respiring air can improve O2 delivery and that hyperoxia interferes with this process.

Keywords

Oxygen Extraction Arterial Oxygen Tension Haemorrhagic Shock Suxamethonium Chloride Dextran Solution 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Becker, L., Schumacker, P., Nelson,D.P., Saltz, S.A., Rowland, J., Long G.R. and Wood, L.D.H. (1985). Influence of FIO2 on the relationship between oxygen delivery and uptake (V02) in the dog. Fed. Proc. 44, 908.Google Scholar
  2. Biro, G.P. (1982). Comparison of acute cardiovascular effects and oxygen-supply following haemodilution with dextran, stroma-free haemoglobin solution and fluorocarbon suspension. Cardiovasc. Res. 16, 194–204.Google Scholar
  3. Biro, G.P. (1983). Fluorocarbon and dextran hemodilution in myocardial ischemia. Canad. J. Surg. 26, 163–168.Google Scholar
  4. Cain S.M. (1977). Oxygen delivery and uptake in dogs during anemic and hypoxic hypoxia. J. Appl. Physiol.: Respirat. Environ. Exercise. Physiol. 42, 228 – 234.Google Scholar
  5. Chapler, C.K., Cain, S.M. and Stainsby, W.N. (1984). The effects of hyperoxia on oxygen uptake during acute anemia. Canad. J. Physiol. Pharmac. 62, 809–814.Google Scholar
  6. Clark, A., Federspiel, W.J., Clark, P.A.A. and Cokelet, G.R. (1985). Oxygen delivery from red cells. Biophys. J. 47, 171–181.Google Scholar
  7. Clark, L.C., Moore, R.E., Diver, S. and Miller, M. (1979). A new look at the vapour pressure problem in red cell substitutes. In: Proceedings of the IVth International Symposium and Perfluorochemical Blood Substitutes, Excerpta Medica, Amsterdam. pp. 55 – 67.Google Scholar
  8. Duling, B.R. (1972). Microvascular responses to alterations in oxygen tension. Circ. Res. 31, 481–489.Google Scholar
  9. Erdmann, W. (1982). 02 diffusion coefficients. In: Oxygen Carrying Colloidal Blood Substitutes. Eds Frey, R., Beisbarth, H., Stossek, K., W. Zuckschwerdt Verlag, Munich, p. 143.Google Scholar
  10. Faithfull, N.S., Erdmann, W. and Fennema, M. (1986). Oxygen tensions in the ischaemic myocardium following haemodilution with fluorocarbons or dextran. Brit. J. Anaesth. 58, 1013–1040.Google Scholar
  11. Fan, F-C., Chen, R.Y.Z., Schuessler, G.B. and Chien, S. (1980). Effects of hematocrit variations on regional hemodynamics and oxygen transport in the dog. Am. J. Physiol. 238, H545 – H552.Google Scholar
  12. Grote, J., Steuer, K., Muller, R., Sontgerath, C. and Zimmer, K. (1985). 02 and CO2 solubility of fluorocarbon emulsion Fluosol-DA 20% and 02 and CO2 dissociation curves of blood-Fluosol-DA 20% mixtures. In: Oxygen Transport to Tissue-VII. Eds Kreuzer, F., Cain, S.M., Turek, Z. and Goldstick, T.K., Plenum Press, New York and London, ( Adv. Exp. Med. Biol. 191, 453–461 ).Google Scholar
  13. Hellums, J.D. (1977). The resistance to oxygen transport in the capillaries relative to that in the surrounding tissue. Microvasc. Res. 13, 1131–136.Google Scholar
  14. Kolodgie, F.D., Dawson, A.K., Forman, M.B. and Virmani, R. (1985). Effect of perfluorochemical ( Fluosol-DA) on infarct morphology in dogs. Virchows Arch. B, 50, 119–134.Google Scholar
  15. Krogh, A. (1919). The number and distribution of capillaries in muscles with calculations of the oxygen partial pressure head necessary for supplying the tissue. J. Physiol. 52, 409 – 415.Google Scholar
  16. Lindbom, L. and Arfors, K-E. (1984). Non-homogeneous blood flow distribution in the rabbit tenuissimus muscle. Acta Physiol. Scand. 122, 225–233.Google Scholar
  17. Mellits, D.E. (1968). Statistical methods. In: Human Growth. Ed. Cheek, D.B., Lea and Febiger, Philadelphia, pp. 19 – 38.Google Scholar
  18. Naito, R. and Yokoyama, K. (1978). Perfluorochemical Blood Substitutes. Technical Information Series No. 5, Green Cross Corporation, Osaka.Google Scholar
  19. Rasio, E.A. and Goresky, C.A. (1979). Capillary limitation of oxygen diffusion in the isolated rete mirabilis of the eel (Anguilla anguillaris). Circ. Res. 44. 495–503.Google Scholar
  20. Rude, R. E., Bush, L.R. and Tilton, G.D. (1984). Effects of fluorocarbons with and without oxygen supplementation on cardiac hemodynamics and energetics. Am.J. Cardiol. 54, 880–883.Google Scholar
  21. Rude, R.E., Glogar, D., Khuri, S.F., Kloner, R.A., Karaffa, S., Muller, J. E., Clark, L.C. and Braunwald, E. (1982). Effect of intravenous fluorocarbons during and without 02 enhancement on acute myocardial ischemic injury assessed by measurement of intramyocardial gas tensions. Am. Heart. J. 103, 986–995.Google Scholar
  22. Schwartz, S., Frantz, R.A. and Shoemaker, W.C. (1981). Sequential hemodynamic and oxygen transport responses in hypovolemia, anemia and hypoxia. Am. J. Physiol. 241, H864 – H871.Google Scholar
  23. Sinha, A.K. (1969). Oxygen Uptake and Release by Red Cells through Capillary Wall and Plasma Layer. Thesis, University of California, San Francisco, U.S.A.Google Scholar
  24. Smith, A.R., van Alphen, W., Faithfull, N.S. and Fennema, M. (1985). Limb preservation in replantation surgery. J. Plast. Reconstr. Surg. 75, 227–237.Google Scholar
  25. Sutherland, G.R., Farrar, J.K. and Peerless, S.J. (1984). The effect of Fluosol-DA on oxygen availability in focal ischemia. Stroke, 15, 829 – 835.CrossRefGoogle Scholar
  26. Zander, R. (1978). Oxygen transport by solutions for blood replacement in comparison with other infusion solutions. Klin. Wschr. 56, 567–573.Google Scholar
  27. Zander, R. and Makowski, H.V. (1982). Life without haemoglobin? In: Oxygen Carrying Colloidal Blood Substitutes. Eds Frey, R., Beisbarth, H., Stossek, K., W. Zuckschwerdt Verlag, Munich, pp. 133 – 141.Google Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • N. S. Faithfull
    • 2
  • S. M. Cain
    • 1
  1. 1.Department of Physiology and BiophysicsUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of AnaesthesiaUniversity of Manchester, Hope HospitalManchesterUK

Personalised recommendations