OBJECTIVETo examine the effect of different infusion volume on hemodynamics of portal hypertension (PHT) canines after hemorrhagic shock (HS).

METHODSPHT canine models were made by coarctating a half main portal vein with silk line chronic embolization. Two weeks later, the canine models were assigned to hemorrhagic shock by femoral artery venesection quickly. They were divided into two groups: large volume infusion group (n=6) and small volume infusion group (n=6). Hemodynamics indexes of PHT canines after HS were monitored continuously. We also examined the effect of different infusion volume on hemodynamics.

RESULTSPHT canines showed a series of hemodynamics changes in hemorrhagic shock stage, which aggravated hemodynamics disorder in PHT. After quick infusion, MAP, IVCP, PVP, PVPG, PVBF, HABF, and HBF increased significantly. These indexes in large volume infusion group were higher than those in small volume infusion group. PVR, SVR, HAR decreased significantly. PVP, PVPG, PVBF, HABF, and HBF showed a rebound increase above baseline values in large volume infusion group. The changes of PVP, PVPG, PVBF, HABF, and HBF were parallel with MAP and IVCP and without rebound increase in small volume infusion group. In large volume infusion group PVPG increased earlier and more significant than PVP and exceeded baseline by 13% (2.58 0.37) kPa, so the danger of rebleeding rose greatly. In small volume infusion group PVPG was over 22% (1.67 0.27) kPa lower than baseline, which infers that the danger of rebleeding reduced greatly. SVR and HAR were lower in large volume infusion group. PVP, PVPG, PVBF, HABF, and HBF showed a positive correlation with accumulated vein infusion volume. PVR showed a positive correlation with accumulated vein infusion volume in small volume infusion group. HAR showed a negative correlation with accumulated vein infusion volume in large volume infusion group.

CONCLUSIONSPHT canines after HS show a rebound increase of PVP, PVPG, PVBF, HABF, and HBF above baseline values in large volume infusion group. In small volume infusion group, however, no rebound increase is noticed. Large volume infusion may cause PVP, PVPG, PVBF, HABF, and HBF increase higher than small volume infusion.