Abstract
Purpose: To investigate the sequential changes in heart rate (HR), autonomic nervous activity presented by the spectral analysis of heart rate variability (HRV), hemodynamics and metabolism during massive hemorrhage and progressive hemorrhagic shock in dogs.
Methods: Twelve dogs were subjected to acute massive hemorrhage until mean arterial pressure (MAP) reached 50 mmHg. Then bleeding was stopped and they were allowed to reach a plateau phase. They were divided, post hoc, into bradycardic or tachycardic groups according to their HR response to the acute massive hemorrhage. After reaching a plateau phase, the dogs were further bled to keep their MAP around 50 mmHg (progressive hemorrhagic shock). Their heart rate power spectra were quantified into low-frequency (LF) (0.04–0.15 Hz) and high-frequency (HF) (0.15–0.4 Hz) components.
Results: In the bradycardic group, both LF and HF increased after massive hemorrhage, but during progressive hemorrhagic shock these components decreased while HR increased. In the tachycardic group, LF increased after massive hemorrhage, but during progressive hemorrhagic shock LF decreased with continuous suppression of HF.
Conclusion: Massive hemorrhage caused two types of HR response: bradycardia and tachycardia. The HRV profile showed differential autonomic characteristics, and could be a valuable tool in assessing various degrees of hemorrhagic shock.
Résumé
Objectif: Examiner les changements de fréquence cardiaque (FC), l’activité nerveuse autonome selon l’analyse spectrale de la variabilité de la fréquence cardiaque (VFC), l’hémodynamie et le métabolisme pendant une hémorragie massive et un choc hémorragique progressif, chez des chiens.
Méthode: Douze chiens ont été soumis à une hémorragie aiguë massive jusqu’à ce que la tension artérielle moyenne (TAM) atteigne 50 mmHg. Puis, on a arrêté le saignement et laissé la pression parvenir à un plateau. On a, en conséquence, réparti les animaux en groupe bradycardie ou tachycardie selon le compotement de la FC pendant l’hémorragie aiguë massive. Un plateau une fois atteint, les chiens ons subi une autre hémorragie pour amener leur TAM autour de 50 mmHg (choc hémorragique progressif). Le spectre de la puissance de la fréquence cardiaque a été quantifié en composantes de basses fréquences (BF) (0,04–0,15 Hz) et de hautes fréquences (HF) (0,15–0,4 Hz).
Résultats: Dans le groupe bradycardie, les BF et HF ont augmenté après l’hémorragie massive, mais lors du choc hémorragique progressif, ces composantes ont diminué pendant que la FC augmentait. Dans le groupe tachycardie, les BF ont augmenté après l’hémorragie massive, mais lors du choc, elles ont baissé en même temps que survenait la suppression continue des HF.
Conclusion: L’hémorragie massive a causé deux types de réaction de la FC: la bradycardie et la tachycardie. Le profil de VFC a affiché des caractéristiques autonomes différentielles, ce qui en fait un outil valable pour évaluer différents degrés de choc hémorragique.
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This study was performed at the Department of Anesthesiology, Nagoya University School of Medicine, Nagoya, Japan.
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Kawase, M., Komatsu, T., Nishiwaki, K. et al. Heart rate variability during massive hemorrhage and progressive hemorrhagic shock in dogs. Can J Anesth 47, 807–814 (2000). https://doi.org/10.1007/BF03019486
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DOI: https://doi.org/10.1007/BF03019486