Effects of Reduction in Viscosity by Means of Hemodilution (Dextran 40) and Defibrination (Arvin) Using a Shock Model with Extracorporeal Circulation
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A reduction in viscosity was induced by means of hemodilution (dextran 40, 5%) and defibrination (Arvin) in dogs during an automatically controlled total cardiopulmonary bypass (experimental model of an “isolated peripheral circulation”). A shock protocol was followed by stepwise transfer (5 ml/kg body weight per 5 minutes) of blood to the oxygenator, the weight of which was controlled automatically, until the aortic pressure fell to 35 mmHg. After a period of one hour at an aortic pressure of 35 mmHg, the shed blood was reinfused into the dog.
In the case of Arvin, significant differences were observed between the Arvin group (series A) and the control group (series C) in relation to a higher survival rate, a lower occurrence of the reversal phenomenon (R.P.), a higher aortic pressure (PAo) and flow (Q), a lower peripheral resistance (TSR), a higher transcutaneous PO2 (TcPO2), O2-consumption (VO2) and O2-availability (O2 AV), and a lower O2-extraction (O2EX) and viscosity at the lower shear rates (ηLS).
There were also significant differences between the hemodilution group (series H) and the control group (series C): the flow Q was higher, the peripheral resistance (TSR) lower, the O2-consumption (VO2) higher and the viscosity lower at both high and low shear rates (TηHS and ηLS).
When the heart and lungs are bypassed, as in the experimental set-up used here, it appears that both hemodilution with dextran 40 and especially a reduction in blood viscosity by means of defibrination represent an effective protection for conditions characterized by a low-flow state such as shock.
KeywordsShear Rate Blood Viscosity Peripheral Resistance Aortic Pressure Extracorporeal Circulation
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