Regional hypothermia improves gastric microcirculatory oxygenation during hemorrhage in dogs

PLoS One. 2019 Dec 10;14(12):e0226146. doi: 10.1371/journal.pone.0226146. eCollection 2019.

Abstract

Mild systemic hypothermia increases gastric mucosal oxygenation (μHbO2) during hemorrhagic shock in dogs. In the context of critical blood loss hypothermia might be fatal due to adverse side effects. Selective regional hypothermia might overcome these limitations. The aim of our study was to analyze the effects of regional gastric and oral mucosal hypothermia on μHbO2 and perfusion (μflow). In a cross-over study six anesthetized dogs were subjected to local oral and gastric mucosal hypothermia (34°C), or maintenance of local normothermia during normovolemia and hemorrhage (-20% blood volume). Macro- and microcirculatory variables were recorded continuously. During normovolemia, local hypothermia increased gastric microcirculatory flow (μflow) without affecting oxygenation (μHbO2) or oral microcirculation. During mild hemorrhagic shock gastric μHbO2 decreased from 72±2% to 38±3% in the normothermic group. This was attenuated by local hypothermia, where μHbO2 was reduced from 74±3% to 52±4%. Local perfusion, oral microcirculation and macrocirculatory variables were not affected. Selective local hypothermia improves gastric μHbO2 during hemorrhagic shock without relevant side effects. In contrast to systemic hypothermia, regional mucosal hypothermia did not affect perfusion and oxygen supply during hemorrhage. Thus, the increased μHbO2 during local hypothermia rather indicates reduced mucosal oxygen demand.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cross-Over Studies
  • Dogs
  • Female
  • Hemorrhage / physiopathology
  • Hemorrhage / therapy*
  • Hypothermia, Induced*
  • Microcirculation*
  • Oxygen / blood
  • Stomach / blood supply*

Substances

  • Oxygen

Grants and funding

This work was supported by a grant of the Strategic Research Fund, Heinrich-Heine-University (No. 1229) to CV. We acknowledge support by the Heinrich-Heine-University Duesseldorf to cover the publication fee. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.