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June 1972, Vol 104, No. 6 >
ARTICLE | June 1972

Hemodynamics of Disseminated Intravascular Coagulation: Title and subTitle BreakEffects of Intra-Aortic Thrombin Infusions on Renal and Mesenteric Blood Flow in the Dog FREE

Johan Hoie, MD; Worthington G. Schenk, Jr., MD, FACS
[+] Author Affiliations

Accepted for publication Dec 8, 1971.

Reprint requests to 462 Grider St, Buffalo (Dr. Schenk).


Arch Surg. 1972;104(6):838-841. doi:10.1001/archsurg.1972.04180060086021
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Cardiac output and renal and superior mesenteric artery flow were measured with noncannulating electromagnetic flow probes during and after intra-aortic infusion of thrombin (75 National Health [NIH] units/ kg body weight during 30 minutes) in the dog. The infusion provoked an episode of intravascular coagulation during which 60% of the plasma fibrinogen was consumed. The cardiac output dropped 24%, renal flow decreased 73%, and mesenteric blood flow increased 6%. After the infusion stopped, this regional flow redistribution abated and the renal and mesenteric flow almost regained their initial share of cardiac output within 30 minutes. The thrombin infusion induced vasoconstriction of the renal and vasodilatation of the mesenteric vasculature limited to the period of infusion. Heparinization prevented both these reactions and the consumption of fibrinogen. The importance of thrombin released vasoactive substances in the hemodynamic response to thrombin is suggested.

REFERENCES

1 +
Hardaway RM: Syndromes of Disseminated Intravascular Coagulation . Springfield, Ill, Charles C Thomas Publisher, 1966;.
2 +
McKay DG: Disseminated Intravascular Coagulation: An Intermediary Mechanism of Disease . New York, Harper & Row Publishers Inc, 1965;.
3 +
Hardaway RM:  Disseminated intravascular coagulation syndromes . Arch Surg 83:842, 1961;.
4 +
Olsson P, Delin NA:  Femoral arterial flow changes following intra-arterial injection of thrombin and thromboplastin . Trans Amer Soc Artif Intern Organs 11:318, 1965;.
5 +
Schenk WG Jr, Dedichen H:  Electronic measurement of blood flow . Amer J Surg 114:111, 1956;.
6 +
Ellis BC, Stransky A:  A quick and accurate method for the determination of fibrinogen in plasma . J Lab Clin Med 58:477, 1961;.
7 +
Girolami A, Cliffton EE, Agostino D:  Hemorrhagic syndrome in the dog induced by intravenous thrombin . Thromb Diath Haemorrh 16:243, 1966;.
8 +
Grette K:  Studies on the mechanism of thrombin-catalyzed hemostatic reactions in blood platelets . Acta Physiol Scand 56( (suppl 195) ):1962;.
9 +
Packham MA, Nishizawa EE, Mustard JF:  Response of platelets to tissue injury . Biochem Pharmacol , (suppl 171) , 1968;.
10 +
Hoie J, Schenk WG Jr: Experimental intravascular coagulation. J Trauma to be published.
11 +
Delin A, Olsson P, Teger-Nilsson AC:  Vasodilatation in the canine leg caused by intra-arterial infusion of thrombin and tissue thromboplastin . Cardiovasc Res 1:371, 1967;.
12 +
Olsson P, Swedenborg J, Teger-Nilsson AC:  Thrombin-induced vasodilatation and hypotension in the dog: Role of fibrinogen, plasma kinins and blood cells . Cardiovasc Res 3:56, 1969;.
13 +
Regoeczi E, Brain MC:  Organ distribution of fibrin in disseminated intravascular coagulation . Brit J Haemat 17:73, 1969;.
14 +
Hardaway RM, McKay DG, Hollowell OW:  Vascular spasm and disseminated intravascular coagulation . Arch Surg 83:173, 1961;.
15 +
Palmerio C, Ming SC, Frank E, Fine J:  The role of the sympathetic nervous system in the generalized Shwartzman's reaction . J Exp Med 115:609, 1962;.
16 +
Fine J, Rutenberg S, Schweinburg FB:  The role of the reticuloendothelial system in haemorrhagic shock . J Exp Med 110:547, 1959;.
17 +
Hysell JW, Bohr DF:  Renal vascular response to plasma and to known vasoactive substances . Proc Soc Exp Biol Med 120:432, 1970;.
18 +
Thurau K:  Renal hemodynamics . Amer J Med 36:698, 1964;.

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1 +
Hardaway RM: Syndromes of Disseminated Intravascular Coagulation . Springfield, Ill, Charles C Thomas Publisher, 1966;.
2 +
McKay DG: Disseminated Intravascular Coagulation: An Intermediary Mechanism of Disease . New York, Harper & Row Publishers Inc, 1965;.
3 +
Hardaway RM:  Disseminated intravascular coagulation syndromes . Arch Surg 83:842, 1961;.
4 +
Olsson P, Delin NA:  Femoral arterial flow changes following intra-arterial injection of thrombin and thromboplastin . Trans Amer Soc Artif Intern Organs 11:318, 1965;.
5 +
Schenk WG Jr, Dedichen H:  Electronic measurement of blood flow . Amer J Surg 114:111, 1956;.
6 +
Ellis BC, Stransky A:  A quick and accurate method for the determination of fibrinogen in plasma . J Lab Clin Med 58:477, 1961;.
7 +
Girolami A, Cliffton EE, Agostino D:  Hemorrhagic syndrome in the dog induced by intravenous thrombin . Thromb Diath Haemorrh 16:243, 1966;.
8 +
Grette K:  Studies on the mechanism of thrombin-catalyzed hemostatic reactions in blood platelets . Acta Physiol Scand 56( (suppl 195) ):1962;.
9 +
Packham MA, Nishizawa EE, Mustard JF:  Response of platelets to tissue injury . Biochem Pharmacol , (suppl 171) , 1968;.
10 +
Hoie J, Schenk WG Jr: Experimental intravascular coagulation. J Trauma to be published.
11 +
Delin A, Olsson P, Teger-Nilsson AC:  Vasodilatation in the canine leg caused by intra-arterial infusion of thrombin and tissue thromboplastin . Cardiovasc Res 1:371, 1967;.
12 +
Olsson P, Swedenborg J, Teger-Nilsson AC:  Thrombin-induced vasodilatation and hypotension in the dog: Role of fibrinogen, plasma kinins and blood cells . Cardiovasc Res 3:56, 1969;.
13 +
Regoeczi E, Brain MC:  Organ distribution of fibrin in disseminated intravascular coagulation . Brit J Haemat 17:73, 1969;.
14 +
Hardaway RM, McKay DG, Hollowell OW:  Vascular spasm and disseminated intravascular coagulation . Arch Surg 83:173, 1961;.
15 +
Palmerio C, Ming SC, Frank E, Fine J:  The role of the sympathetic nervous system in the generalized Shwartzman's reaction . J Exp Med 115:609, 1962;.
16 +
Fine J, Rutenberg S, Schweinburg FB:  The role of the reticuloendothelial system in haemorrhagic shock . J Exp Med 110:547, 1959;.
17 +
Hysell JW, Bohr DF:  Renal vascular response to plasma and to known vasoactive substances . Proc Soc Exp Biol Med 120:432, 1970;.
18 +
Thurau K:  Renal hemodynamics . Amer J Med 36:698, 1964;.

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