S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) The Seoul Journal of Medicine The Seoul Journal of Medicine Vol. 16 No.1 (1975)
급성 실혈성쇽크 때의 심장박출량 및 산-염기 균형
Cardiac Output and Acid-Base Balance During Acute Hemorrhagic Shock
- Issue Date
- 서울대학교 의과대학
- Seoul J Med, Vol.16 No.1, pp. 18-24
- Cardiac output and arteria-venous pH, Peo2 was
determined after acute hemorrhage from a jugular
vein. the amount 10. 20 and 30% of estimated total
blood volume of dogs. The bleeding period lasted
approximately one hour on each 10% of blood loss.
Cardiac output was measured analyzing the saline
dilution curve drawn on physiograph, the extra-arte
rial conductivity. using Stewart-Hamilton formula.
1. After blood loss of 10. 20 and 30% of total
blood volume. cardiac output decreased from 103C±5)
ml/min/kg of normal to 98(±7). 8IC±8) and 66C±
11) ml/min/kg. respectively. Decrement of cardiac
output were consistant and significant after more
than 20% of blood loss. Stroke volume changed from
7.3C±0.49) ml to 6. 5C±0. 58). 4.5(±0.61J and 4.4
C±0.461ml. respectively. The decrease of stroke
volume appeared relatively earlier than the decrease
of blood pressure and cardiac output in successive
bleeding. this would be associated with the decreased
venous return. 2. During the above succeeding acute blood loss.
arterial blood pressure were decreased significantly
from 153(±7) mmHg to 138 、±8). 107(±9) and
71(±6) mmHg. indicating more marked pressure drop
can be produced after each successive blood 105s.
3. Total peripheral resistance changed from O. 131
(±0.012) mmHg/ml/min to o. 132(±0. 019). 0.110
<±0.020) and 0.100(±0. 014) mmHg/mI/min. respectively.
It appears. therefore. that pressure drop
after more than 30% of blood loss is not only due
to the decrement of cardiac output but decrement
of peripheral resistance.
5. Acid-Base balance during the acute hemorrhagic
shock was primarily metabolic origin. arterial blood
pH changed from 7.42 to 7.43. 7.35 and 7.38.
venous blood pH changed from 7. 38 to 7.36. 7.26 and
7.20. respectively. The pH changed markedly and
significantly after more than 20% of blood loss. with
negligible change of arterial and venous PCOI • Plasma
potassium ion concentration increased as the increase
of blood loss from 3.0(±0.14) mEq/L to 3.4(±
0.20). 4. 3(±O. 43) and 3. 9(±0. 29) mEq/L.