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Should Normothermia Be Restored and Maintained during Resuscitation after Trauma and Hemorrhage?

 

作者: Yasuaki,   Mizushima Ping,   Wang William,   Cioffi Kirby,   Bland Irshad,  

 

期刊: The Journal of Trauma: Injury, Infection, and Critical Care  (OVID Available online 2000)
卷期: Volume 48, issue 1  

页码: 58-58

 

ISSN:0022-5282

 

年代: 2000

 

出版商: OVID

 

关键词: Hypothermia;Rewarming;Cardiac output;Cardiac performance Hemorrhagic shock;Regional blood flow\

 

数据来源: OVID

 

摘要:

Background:Although hypothermia often occurs after trauma and has protective effects during ischemia and organ preservation, it remains unknown whether maintenance of hypothermia or restoring the body temperature to normothermia during resuscitation has any deleterious or beneficial effects on heart performance and organ blood flow after trauma-hemorrhage.Methods:Male rats underwent laparotomy (i.e., induced trauma) and were exsanguinated to and maintained at a mean arterial pressure of 40 mm Hg until 40% of the maximum shed volume was returned in the form of Ringer’s lactate. Body temperature decreased from approximately 36.5°C to below 32°C. The animals were then resuscitated with four times the volume of maximal bleedout with Ringer’s lactate. In one group, body temperature was rewarmed to 37°C during resuscitation. In another group, body temperature was maintained at hypothermia (32°C) for 4 hours after resuscitation. In an additional group, the body temperature was kept at 37°C during hemorrhage as well as during resuscitation. Left ventricle performance parameters such as maximal rate of left ventricular pressure increase and decrease (±dP/dtmax) were measured up to 4 hours. Cardiac output and regional blood flow were determined by radioactive microspheres at 4 hours after the completion of resuscitation.Results:The maintenance of normothermia during hemorrhage or prolonged hypothermia after resuscitation depressed the left ventricular performance parameters, cardiac output, and regional blood flow in various organs. Rewarming the body to normothermia during resuscitation, however, significantly increased heart performance, cardiac output (from hypothermia 16.2 ± 1.4 to 22.3 ± 1.4 mL/min per 100 g body weight,p< 0.05) and total hepatic blood flow (from hypothermia 117.5 ± 5.3 to 166.0 ± 9.3 mL/min per 100 g tissue,p< .05).Conclusion:Our data indicate that restoration of normothermia during resuscitation improves cardiac function and hepatic blood flow compared with hypothermia.

 



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