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Rivista di Medicina Interna

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Periodicità: Trimestrale

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 2000 Giugno;42(2):109-17


Beneficial effects of iloprost during experimentally induced hemorrhagic shock

Katircioglu S. F., Ulus A. T., Gökçe P. *, Apaydin N. *, Ayaz S. **, Dalva K. **, Koç B. *, Atalay F.

From the Cardiovascular Surgery Department of Türkiye Yüksek I.htisas Hospital of Ankara, Turkey
*Veterinary Faculty of University of Ankara, Turkey
**Immunology and Biochemistry Department of Türkiye Yüksek I.htisas Hospital of Ankara, Turkey

Background. The aim of the ­study was to eval­uate the effi­cacy of ilo­prost on myo­car­dial insuf­fi­ciency asso­ciated ­with hypo­vo­lemic ­shock in ­dogs. We ­designed the ­study as a con­trolled ran­dom­ized ­study.
Methods. Sixteen ­mixed-­breed ­dogs ­were ­included ­into the ­study and ­divided ­into two ­equal ­groups as the con­trol and ilo­prost ­groups. Mean arte­rial pres­sure was ­reduced to 45 mmHg by with­drawing the arte­rial ­blood ­into ­citrated ­bags. The con­trol ­group did not ­receive any ­drug but the ­other ­group ­received ilo­prost at a ­rate of 20 ng/­kg/min by an infu­sion ­pump. Iloprost infu­sion was ­started 30 min ­after the ­blood pres­sure was ­reduced to 45 mmHg. All meas­ure­ments ­were ­made ­before ­removal of ­blood, 45 min ­after exsan­gui­na­tion and at 1 ­hour inter­vals for 3 ­hours. Left ven­tric­ular ­stroke ­work ­index was meas­ured 72 ­hours ­after the ­study. The hemo­dy­namic and bio­chem­ical param­e­ters and ­blood gas anal­ysis ­were ­obtained.
Results. After hem­or­rhage, car­diac ­index (CI) ­decreased sig­nif­i­cantly ­from 132±14 to 51±8 ml/kg/min in the con­trol ­group and ­from 128±11 ml/kg/min to 47±13 ml/­kg/min in the ilo­prost ­group, respec­tively but at the end of the ­third ­hour it was 81±8 ml/kg/min in the con­trol ­group and 105±6 ml/kg/min in the ilo­prost ­group (p<0.05). Tumor ­necrosis ­factor-α (TNFα) ­was 41±8 pg/ml in the con­trol ­group and 18±6 in the ilo­prost ­group 3 ­hours ­after ­bleeding (p<0.05). Tumor ­necrosis ­factor-α con­cen­tra­tion was sig­nif­i­cantly ­higher in the con­trol ­group ­than in the ilo­prost ­group. There was no sig­nif­i­cant dif­fer­ence in pH ­between the ­groups but ­actual bicar­bo­nate con­cen­tra­tions ­were dif­ferent ­between the ­groups (p<0.05). At the end of the ­third ­hour ­total ­body ­oxygen con­sump­tion was 105±11 ml/ min in the con­trol ­group and 132±12 ml/min in the ilo­prost ­group (p<0.05). Oxygen ­delivery 3 ­hours ­after hem­or­rhage was 201±19 ml/min in the con­trol ­group and 252±24 ml/min in the ilo­prost ­group (p>0.05). Left ven­tric­ular ­stroke ­work ­index was ­higher in the ilo­prost ­group (p<0.05).
Conclusions. Hemorrhagic ­shock ­causes ­tumor ­necrosis ­factor-α ­release ­which may ­lead to mul­tiple ­organ ­failure. Organ dys­func­tion ­still per­sists ­even ­after the appro­priate treat­ment. Iloprost atten­u­ates the ­release of ­tumor ­necrosis ­factor-α ­which may ­improve the ­adverse ­effects of hemor­rhagic ­shock.

lingua: Inglese


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