Related Experiment Video
Updated: Jul 14, 2026
07:51
Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
Resuscitation from hemorrhagic shock with hydroxyethyl starch and coagulation changes
Pedro Cabrales1, Amy G Tsai, Marcos Intaglietta
1La Jolla Bioengineering Institute, La Jolla, California 92037, USA. pcabrales@ucsd.edu
Shock (Augusta, Ga.)
|June 15, 2007
Summary
High-MW hydroxyethyl starch (HES) improved resuscitation outcomes after hemorrhagic shock compared to low-MW HES. Both HES types impaired thrombus formation, likely due to hemodilution, not HES molecular weight.
Area of Science:
- Biomedical Engineering
- Physiology
- Pharmacology
Background:
- Fluid resuscitation is crucial after hemorrhagic shock, but fluid choice impacts outcomes.
- Hydroxyethyl starch (HES) is used, but its effects based on molecular weight (MW) and degree of substitution (DS) require clarification.
Purpose of the Study:
- To compare the effects of low-MW HES (L-HES) and high-MW HES (H-HES) on resuscitation from hemorrhagic shock.
- To evaluate their impact on microvascular perfusion, rheological properties, and coagulation.
Main Methods:
- Hemorrhagic shock induced in a hamster window chamber model.
- Resuscitation with L-HES (130 kd, DS 0.40) or H-HES (670 kd, DS 0.75).
- Assessment of systemic parameters, microvascular perfusion, and laser-induced microthrombi formation.
Main Results:
- H-HES improved systemic conditions, microcirculatory flow, and metabolic recovery versus L-HES.
- Mean arterial pressure recovery was better with H-HES.
- Both HES groups showed impaired thrombus formation compared to sham, without significant differences between L-HES and H-HES for larger injuries.
Conclusions:
- HES fluid resuscitation may increase bleeding risk, primarily due to hemodilution effects on platelet availability and shear stress, not HES MW or DS.
- H-HES offers potential for longer-lasting volume effects due to its persistence.
Related Concept Videos
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
01:05Introduction to Hemostasis
Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized, and...
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized, and...
01:24Blood Pressure Imbalances and Circulatory Shock
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...