Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1980 Jul;192(1):86–94. doi: 10.1097/00000658-198007000-00015

Pulmonary and systemic hemodynamics during hemorrhagic shock in baboons.

C E Bredenberg, S Nomoto, W R Webb
PMCID: PMC1344811  PMID: 6773481

Abstract

The pulmonary and systemic hemodynamic response to four hours of hemorrhagic shock and resuscitation has been studied in 17 baboons using both open and closed chest models. No pulmonary artery (PA) hypertension occurred during shock or resuscitation except for an increase in lft ventricular end diastolic pressure (LVEDP) secondary to intravascular volumee overload with Dextran. Pulmonary vascular resistance (PVR) increased during shock but returned to control levels with reinfusion of shed blood and correction of acidosis. PVR was moderately elevated following reinfusion of shed blood if acidosis was not corrected or if volum resuscitation was inadequate. No increase in gradients occurred between PA pressure and left atrial (LA) pressure or LVEDP and there was no gradients between small pulmonary vein and LA pressure. Arterial PO2 uniformly increased during shock and remained at or above control levels of reinfusion. Gross or histologic evidence of "congestive atelectasis" or "shock lung" was not observed. These observations suggest that in the subhuman primate, hemorrhage alone does not produce significant injury to the lung during shock or the immediate postresuscitation interval. Hemorrhage alone did not produce changes in the lung which would result in increased pulmonary microvascular hydrostatic pressure following appropriate resuscitation.

Full text

PDF
86

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRAUNWALD E., FISHMAN A. P., COURNAND A. Time relationship of dynamic events in the cardiac chambers, pulmonary artery and aorta in man. Circ Res. 1956 Jan;4(1):100–107. doi: 10.1161/01.res.4.1.100. [DOI] [PubMed] [Google Scholar]
  2. Buckberg G. D., Dowell A. R. The effects of hemorrhagic shock and pulmonary ischemia on lung compliance and structure in baboons. Surg Gynecol Obstet. 1970 Dec;131(6):1065–1072. [PubMed] [Google Scholar]
  3. Buckberg G. D., Lipman C. A., Hahn J. A., Smith M. J., Hennessen J. A. Pulmonary changes following hemorrhagic shock and resuscitation in baboons. J Thorac Cardiovasc Surg. 1970 Mar;59(3):450–460. [PubMed] [Google Scholar]
  4. Collins J. A., Simmons R. L., James P. M., Bredenberg C. E., Anderson R. W., Heisterkamp C. A., 3rd Acid-base status of seriously wounded combat casualties. II. Resuscitation with stored blood. Ann Surg. 1971 Jan;173(1):6–18. doi: 10.1097/00000658-197101000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Collins J. A. The causes of progressive pulmonary insufficiency in surgical patients. J Surg Res. 1969 Dec;9(12):685–704. doi: 10.1016/0022-4804(69)90028-6. [DOI] [PubMed] [Google Scholar]
  6. Cotev S., Rosenmann E., Eyal Z., Weinberg H., Shafrir E., Davidson J. T. The role of hypovolemic stress in the production of fat embolism in rabbits. 1. Morphologic alterations of the lungs. Chest. 1976 Apr;69(4):523–528. doi: 10.1378/chest.69.4.523. [DOI] [PubMed] [Google Scholar]
  7. Desai J. M., Kim S. I., Shoemaker W. C. Part I. Sequential hemodynamic changes in an experimental hemorrhagic shock preparation designed to simulate clinical shock. Ann Surg. 1969 Aug;170(2):157–165. doi: 10.1097/00000658-196908000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Esrig B. C., Fulton R. L. Sepsis, resuscitated hemorrhagic shock and "shock lung:" An experimental correlation. Ann Surg. 1975 Sep;182(3):218–227. doi: 10.1097/00000658-197509000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. GERST P. H., RATTENBORG C., HOLADAY D. A. The effects of hemorrhage of pulmonary circulation and respiratory gas exchange. J Clin Invest. 1959 Mar;38(3):524–538. doi: 10.1172/JCI103830. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Garvey J. W., Hagstrom J. W., Veith F. J. Pathologic pulmonary changes in hemorrhagic shock. Ann Surg. 1975 Jun;181(6):870–875. doi: 10.1097/00000658-197506000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Henry J. N., McArdle A. H., Scott H. J., Gurd F. N. A study of the acute and chronic respiratory pathophysiology of hemorrhagic shock. J Thorac Cardiovasc Surg. 1967 Nov;54(5):666–681. [PubMed] [Google Scholar]
  12. Hillen G. P., Gaisford W. D., Jensen C. G. Pulmonary changes in treated and untreated hemorrhagic shock. I. Early functional and ultrastructural alterations after moderate shock. Am J Surg. 1971 Nov;122(5):639–649. doi: 10.1016/0002-9610(71)90292-3. [DOI] [PubMed] [Google Scholar]
  13. Hissen W., Swank R. L. Screen filtration pressure and pulmonary hypertension. Am J Physiol. 1965 Oct;209(4):715–722. doi: 10.1152/ajplegacy.1965.209.4.715. [DOI] [PubMed] [Google Scholar]
  14. Holcroft J. W., Trunkey D. D., Carpenter M. A. Excessive fluid administration in resuscitating baboons from hemorrhagic shock, and an assessment of the thermodye technic for measuring extravascular lung water. Am J Surg. 1978 Mar;135(3):412–416. doi: 10.1016/0002-9610(78)90076-4. [DOI] [PubMed] [Google Scholar]
  15. Keller C. A., Schramel R. J., Hyman A. L., Creech O., Jr The cause of acute congestive lesions of the lung. J Thorac Cardiovasc Surg. 1967 May;53(5):743–753. [PubMed] [Google Scholar]
  16. Kim S. I., Shoemaker W. C. Role of the acidosis in the development of increased pulmonary vascular resistance and shock lung in experimental hemorrhagic shock. Surgery. 1973 May;73(5):723–729. [PubMed] [Google Scholar]
  17. Meyers J. R., Meyer J. S., Baue A. E. Does hemorrhagic shock damage the lung? J Trauma. 1973 Jun;13(6):509–519. doi: 10.1097/00005373-197306000-00004. [DOI] [PubMed] [Google Scholar]
  18. Moss G. S., Das Gupta T. K., Brinkman R., Sehgal L., Newsom B. Changes in lung ultrastructure following heterologous and homologous serum albumin infusion in the treatment of hemorrhagic shock. Ann Surg. 1979 Feb;189(2):236–242. doi: 10.1097/00000658-197902000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Murakami T., Wax S. D., Webb W. R. Pulmonary microcirculation in hemorrhagic shock. Surg Forum. 1970;21:25–27. [PubMed] [Google Scholar]
  20. Proctor H. J., Moss G. S., Homer L. D., Litt B. D. Changes in lung compliance in experimental hemorrhagic shock and resuscitation. Ann Surg. 1969 Jan;169(1):82–92. doi: 10.1097/00000658-196901000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Rutherford R. B., Arora S., Fleming P. W., Monaghan T., Lowenstein D. H. Delayed-onset pulmonary insufficiency in primates resuscitated from hemorrhagic shock. J Trauma. 1979 Jun;19(6):422–431. doi: 10.1097/00005373-197906000-00006. [DOI] [PubMed] [Google Scholar]
  22. Sealy W. C., Ogino S., Lesage A. M., Young W. G., Jr Functional and structural changes in the lung in hemorrhagic shock. Surg Gynecol Obstet. 1966 Apr;122(4):754–760. [PubMed] [Google Scholar]
  23. Tobey R. E., Kopriva C. J., Homer L. D., Solis R. T., Dickson L. G., Herman C. M. Pulmonary gas exchange following hemorrhagic shock and massive blood transfusion in the baboon. Ann Surg. 1974 Mar;179(3):316–321. doi: 10.1097/00000658-197403000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Veith F. J., Hagstrom J. W., Panossian A., Nehlsen S. L., Wilson J. W. Pulmonary microcirculatory response to shock, transfusion, and pump-oxygenator procedures: a unified mechanism underlying pulmonary damage. Surgery. 1968 Jul;64(1):95–108. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES