Influence on liver, renal tissue blood flow, and metaboric function during hemodilution with hypotension

—Hemodilution with 6% hydroxyethyl starch saline and controlled hypotension with sodium nitroprusside—

Abstract

Respiratory and metabolic changes as well as liver and kidney blood flow responses under acute hemodilution and controlled hypotension was studied in 9 mongrel dogs that were anesthetized with isoflurane and paralyzed with Pancuronium. Hemodilution was produced by removal of 20ml/kg whole blood and infusing 6% hydroxyethl starch saline (Salinhes^®) at 1.5 times the volume of blood removed. Subsequently, hypotension to pressure of 70mmHg was induced for 90 minutes by intravenous infusion of Sodium nitroprusside. The results were as follows:
1) The CI significantly increased during hypotension after hemodilution.
2) PVO₂ significantly increased after hemodilution, but showed no significant changes during hypotension. PaO₂ and PaCO₂ showed no significant changes during hypotension after hemodilution.
3) Hepatic and renal cortical blood flow significantly increased after hemodilution, but showed no significant changes during hypotension. Renal medullary blood flow significantly increased after hemodilution and tended to increase during hypotension, although the change was not significant.
4) pH and BE significantly decreased after hemodilution and during hypotension, but there was no significant change between these two periods. The lactate level significantly increased during hypotension, but cyan intoxication induced symptoms, such as an increase in PaO₂ or HR, were not observed.
From these findings, the present technique is considered to be useful for clinical application.