Myocardial utilization of hypertonic glucose during hemorrhagic shock.
Awake pigs were rapidly bled 40% of total blood volume to induce hemorrhagic shock. Immediately after the induction of shock, all pigs received a single intravenous injection of radioactive-labeled glucose-U-14C. Simultaneously with glucose-U-14C injection, ten pigs received single central intravenous injections of unlabeled 50% glucose, four pigs received equiosmolar 25% mannitol, six did not receive either 50% glucose or mannitol, and two received 50% glucose plus insulin. Mean arterial pressure with 50% glucose was 89.9 mm. Hg at 15 minutes of shock and significantly higher than without 50% glucose, 48.3 mm. Hg or after mannitol, 46.7 mm. Hg (P = 0.05). Mean cardiac output at 10 minutes of shock with 50% glucose was 2.24 L. per minute and significantly higher than with mannitol, 1.34 L. per minute, or without 50% glucose, 0.94 L. per minute (P = 0.05.). Evidence for increased anaerobic myocardial utilization of the administered unlabeled 50% glucose was shown by a 12% greater production of unlabeled lactate in the venous coronary sinus blood from unlabeled 50% glucose in contrast to those not given 50% glucose at 10 minutes after shock (P = 0.05). Also, 50% glucose significantly increased mean arterial pressure, cardiac output, and survival over both control groups.
D000693:Anaerobiosis; D000818:Animals; D001794:Blood Pressure; D001810:Blood Volume; D002245:Carbon Dioxide / Q000096:biosynthesis; D002302:Cardiac Output; D005947:Glucose / Q000378:metabolism*; D005950:Glucose Solution, Hypertonic / Q000378:metabolism*; D006339:Heart Rate; D007328:Insulin / Q000378:metabolism; D007773:Lactates / Q000378:metabolism; D008168:Lung / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism*; D011188:Potassium / Q000097:blood; D012771:Shock, Hemorrhagic / Q000378:metabolism* / Q000401:mortality / Q000503:physiopathology; D013552:Swine; D014655:Vascular Resistance
D005950:Glucose Solution, Hypertonic; D007328:Insulin; D007773:Lactates; D002245:Carbon Dioxide; D005947:Glucose; D011188:Potassium