Internal countershock produces myocardial damage and lactate production without myocardial ischemia in anesthetized dogs
The global myocardial extraction of lactate was measured in 13 halothane anesthetized dogs to assess the effect of electric countershock applied directly to the heart. Seven animals received two countershocks of 30 delivered joules each, while six animals were not shocked but were atrially paced to a rate of 190-200, both with and without occlusion of the vena cava to produce a mean arterial pressure of 40-50 mmHg. All animals had substantially positive lactate extraction in the baseline state (36 +/- 10% for countershock group vs. 41 +/- 3% for pacing group). Myocardial lactate extraction reached a markedly negative nadir 2.5 min after countershock (-19 +/- 15%), but returned toward normal by 6 min (10 +/- 6%). Lactate extraction was not significantly changed from baseline in the pacing group. The relationship between changes in regional myocardial blood flow (radiolabeled microspheres) and post-countershock myocardial damage (technetium pyrophosphate uptake) was assessed in six dogs shocked as above. Mean myocardial blood flow was increased minimally immediately after countershock (0.78 +/- 0.08 ml X min-1 X g-1 vs. 1.16 +/- 0.3), but there was no difference in blood flow between damaged and undamaged tissue at either time point. The epicardial-to-endocardial ratio of blood flow was unchanged after countershock (0.97 +/- 0.05 vs. 0.99 +/- 0.08). There was no relationship between myocardial damage and either the absolute amount of blood flow after countershock (r = -0.03) or the change in blood flow compared with the pre-shock period (r = 0.01).
- Research Organization:
- Stanford Univ. School of Medicine, Palo Alto, CA
- OSTI ID:
- 6518446
- Journal Information:
- Anesthesiology; (United States), Vol. 4
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
HEART
ELECTRIC SHOCK
LACTATES
BIOSYNTHESIS
MYOCARDIUM
BLOOD FLOW
BLOOD PRESSURE
DOGS
MICROSPHERES
NECROSIS
PYROPHOSPHATES
TECHNETIUM ISOTOPES
TRACER TECHNIQUES
ANIMALS
BODY
CARBOXYLIC ACID SALTS
CARDIOVASCULAR SYSTEM
ISOTOPE APPLICATIONS
ISOTOPES
MAMMALS
MUSCLES
ORGANS
OXYGEN COMPOUNDS
PATHOLOGICAL CHANGES
PHOSPHORUS COMPOUNDS
SYNTHESIS
VERTEBRATES
550901* - Pathology- Tracer Techniques