Tissue oxygenation after prolonged ischemia in skeletal muscle: therapeutic effect of prophylactic isovolemic hemodilution.
Prolonged ischemia is known to cause severe damage in skeletal muscle and skin as a result of reperfusion failure. Isovolemic hemodilution has been suggested as a modality to reverse microcirculatory disorders by improving flow properties and flow conditions of the blood. The aim of the present study was to investigate whether prophylactic isovolemic hemodilution could improve tissue oxygenation after 4h of pressure induced ischemia in skeletal muscle. In 17 Syrian golden hamsters a dorsal skin fold chamber and two permanent arterial and venous catheters were implanted. Following a recovery period of 48h ischemia was induced for 4h by means of a transparent stamp compressing the tissue within the chamber. In 9 animals (control, hct 43%) measurements of tissue PO2 (platinum multiwire electrode) were performed prior to and 15 min, 2h and 24h after release of ischemia. In 8 animals isovolemic hemodilution with Dextran 60 (hct 29%) was carried out prior to ischemia and measurements of local tissue PO2 were performed as reported for the control group with an additional measurement 30 min after hemodilution. In control animals tissue PO2 decreased significantly (p less than 0.01) from 20.7 +/- 2.4 mmHg prior to ischemia to 8.8 +/- 3.1 mmHg after 15 min of reperfusion; after 24h tissue PO2 was 15.6 +/- 6.1 mmHg. In hemodiluted animals tissue PO2 increased due to hemodilution from 20.9 +/- 1.6 mmHg to 23.5 +/- 2.5 mmHg (p less than 0.05); after 15 min of reperfusion tissue PO2 was 19.8 +/- 6.8 mmHg and remained unchanged for 24h (20.0 +/- 2.5 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)
Dept. of General Surgery, University of Saarland, Homburg, FRG.
M D
MD
Menger
F U
FU
Sack
F
F
Hammersen
K
K
Messmer
D000818:Animals; D006224:Cricetinae; D006400:Hematocrit; D006438:Hemodilution; D007511:Ischemia / Q000378:metabolism* / Q000628:therapy; D008647:Mesocricetus; D009132:Muscles / Q000098:blood supply* / Q000378:metabolism; D010100:Oxygen / Q000032:analysis; D010313:Partial Pressure; D012016:Reference Values; D015424:Reperfusion
D010100:Oxygen