Value of sublingual microcirculation on hemorrhage severity in the pig

doi:10.3877/cma.j.issn.1674-6880.2016.05.008

Abstract

Abstract:

Objective

To investigate the value of sublingual microcirculation on hemorrhage severity in the pig.

Methods

Twenty healthy male pigs were randomized into four groups according to the percentage of blood loss volume (the total blood volume was assessed for 70 ml/kg): sham group, 25% blood loss group, 35% blood loss group and 45% blood loss group, 5 pigs in each group. The levels of mean arterial pressure, cardiac output, blood lactic acid, microvascular flow index (MFI) and perfused vessel density (PVD) were regularly evaluated on 30 min, 1 h, 2 h, 3 h, and 4 h after hemorrhage. The body mass, heart rate, mean arterial pressure, cardiac output, blood lactic acid, MFI and PVD before hemorrhage were compared.

Results

The body mass, heart rate, mean arterial pressure, cardiac output, blood lactic acid, MFI and PVD before hemorrhage all showed no significant differences among four groups (F = 0.156, 0.260, 0.467, 0.417, 0.434, 1.778, 0.149; all P> 0.05). When the volume of blood loss was gradually increased, the mean arterial pressure and cardiac output on 30 min [(117 ± 8), (56 ± 10), (45 ± 4), (31 ± 5) mmHg, (4.80 ± 0.54), (3.32 ± 0.32), (2.35 ± 0.37), (1.67 ± 0.15) L/min], 1 h [(123 ± 4), (89 ± 6), (67 ± 8), (52 ± 8) mmHg, (4.79 ± 0.63), (3.99 ± 0.37), (2.75 ± 0.35), (2.05 ± 0.39) L/min] after hemorrhage decreased (all P< 0.05), blood lactic acid on 1 h after hemorrhage increased [(1.12 ± 0.33), (2.10 ± 0.25), (3.74 ± 1.38), (5.88 ± 1.48) mmol/L; all P< 0.05], and MFI [(2.92 ± 0.09), (2.47 ± 0.28), (1.30 ± 0.14), (0.87 ± 0.27); all P< 0.05] and PVD [(4.95 ± 0.12), (4.20 ± 0.54), (2.98 ± 0.10), (2.64 ± 0.31); all P< 0.05] on 30 min after hemorrhage declined. Pearson correlationanalysis showed that MFI and PVD were positively associated with mean arterial pressure (r = 0.903, 0.923; all P< 0.05) and cardiac output (r = 0.919, 0.919; all P< 0.05), and negatively correlated with blood lactic acid (r = -0.706, -0.745; all P< 0.05).

Conclusion

Sublingual microcirculation can indicate the changes of blood loss in real time, and effectively predict the severity of hemorrhage.

Key words: Microcirculation, Hemorrhage, Microvascular flow index, Perfused vessel density

Zeng Huang, Jiefeng Xu, Guofeng Chen, Hongming Xu, Ya Fang, Haixia Tu, Zilong Li. Value of sublingual microcirculation on hemorrhage severity in the pig[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2016, 09(05): 328-333.

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Figures/Tables 6

References 25

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组别	只数	体质量(kg)	心率(次/min)	MAP(mmHg)	心输出量(L/min^-1)	血乳酸(mmol/L)	MFI	PVD(n/mm)
对照组	5	34.6 ± 0.6	121 ± 11	116 ± 9	4.94 ± 0.25	1.14 ± 0.23	2.97 ± 0.04	4.93 ± 0.23
25%失血组	5	33.3 ± 4.0	119 ± 10	118 ± 5	4.67 ± 0.53	1.00 ± 0.27	2.97 ± 0.04	5.04 ± 0.40
35%失血组	5	33.7 ± 3.2	125 ± 10	116 ± 15	4.69 ± 0.13	1.16 ± 0.30	3.00 ± 0.00	4.99 ± 0.25
45%失血组	5	33.7 ± 3.5	120 ± 17	110 ± 13	4.81 ± 0.60	1.12 ± 0.13	3.00 ± 0.00	5.01 ± 0.08
F值	?	0.156	0.260	0.467	0.417	0.434	1.778	0.149
P值	?	0.925	0.853	0.709	0.743	0.731	0.192	0.929

组别	只数	体质量(kg)	心率(次/min)	MAP(mmHg)	心输出量(L/min^-1)	血乳酸(mmol/L)	MFI	PVD(n/mm)
对照组	5	34.6 ± 0.6	121 ± 11	116 ± 9	4.94 ± 0.25	1.14 ± 0.23	2.97 ± 0.04	4.93 ± 0.23
25%失血组	5	33.3 ± 4.0	119 ± 10	118 ± 5	4.67 ± 0.53	1.00 ± 0.27	2.97 ± 0.04	5.04 ± 0.40
35%失血组	5	33.7 ± 3.2	125 ± 10	116 ± 15	4.69 ± 0.13	1.16 ± 0.30	3.00 ± 0.00	4.99 ± 0.25
45%失血组	5	33.7 ± 3.5	120 ± 17	110 ± 13	4.81 ± 0.60	1.12 ± 0.13	3.00 ± 0.00	5.01 ± 0.08
F值	?	0.156	0.260	0.467	0.417	0.434	1.778	0.149
P值	?	0.925	0.853	0.709	0.743	0.731	0.192	0.929

组别	只数	30 min	1h	2h	3h	4h
对照组	5	117 ± 8	123 ± 4	123 ± 5	121 ± 7	123 ± 6
25%失血组	5	56 ± 10^a	89 ± 6^a	103 ± 12^a	109 ± 4^a	116 ± 7
35%失血组	5	45 ± 4^ab	67 ± 8^ab	82 ± 10^ab	87 ± 16^ab	100 ± 18^a
45%失血组	5	31 ± 5^abc	52 ± 8^abc	68 ± 15^ab	76 ± 17^ab	81 ± 12^ab
F值	?	132.764	91.553	17.998	11.043	9.334
P值	?	< 0.001	< 0.001	< 0.001	< 0.001	0.001

组别	只数	30 min	1h	2h	3h	4h
对照组	5	117 ± 8	123 ± 4	123 ± 5	121 ± 7	123 ± 6
25%失血组	5	56 ± 10^a	89 ± 6^a	103 ± 12^a	109 ± 4^a	116 ± 7
35%失血组	5	45 ± 4^ab	67 ± 8^ab	82 ± 10^ab	87 ± 16^ab	100 ± 18^a
45%失血组	5	31 ± 5^abc	52 ± 8^abc	68 ± 15^ab	76 ± 17^ab	81 ± 12^ab
F值	?	132.764	91.553	17.998	11.043	9.334
P值	?	< 0.001	< 0.001	< 0.001	< 0.001	0.001

组别	只数	30 min	1h	2h	3h	4h
对照组	5	4.80 ± 0.54	4.79 ± 0.63	4.93 ± 0.39	4.83 ± 0.51	4.93 ± 0.51
25%失血组	5	3.32 ± 0.32^a	3.99 ± 0.37^a	4.29 ± 0.53	4.39 ± 0.19	4.58 ± 0.32
35%失血组	5	2.35 ± 0.37^ab	2.75 ± 0.35^ab	3.55 ± 0.47^ab	3.66 ± 1.00^ab	3.79 ± 0.36^ab
45%失血组	5	1.67 ± 0.15^abc	2.05 ± 0.39^abc	2.94 ± 0.37^ab	3.44 ± 0.35^ab	3.37 ± 0.55^ab
F值	?	50.327	33.829	14.622	4.546	11.286
P值	?	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

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