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Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

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Published on: May 21, 2019

Global longitudinal strain changes during hemorrhagic shock: An experimental study.

Laurent Zieleskiewicz¹, Pierre-Géraud Claret^2,3, Laurent Muller^2,3

¹Department of Anesthesiology and Intensive Care, North Hospital, APHM, Aix Marseille Univ., INSERM, INRA, C2VN, Marseille, France.

Turkish Journal of Emergency Medicine

|August 25, 2020

Summary

This summary is machine-generated.

Global longitudinal strain (GLS) increased during hemorrhagic shock and decreased during fluid resuscitation in piglets, demonstrating preload dependence. GLS changes were similar across resuscitation groups.

Keywords:

Hypovolemia strain systolic function

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Area of Science:

Cardiology
Critical Care Medicine
Echocardiography

Background:

Global longitudinal strain (GLS) is a sensitive echocardiographic marker for left ventricular systolic dysfunction.
Hemorrhagic shock (HS) significantly impacts cardiac function, necessitating effective monitoring.
Understanding GLS dynamics during HS and resuscitation is crucial for clinical management.

Purpose of the Study:

To analyze changes in GLS in an anesthetized piglet model of controlled hemorrhagic shock (HS).
To evaluate if GLS changes differ based on resuscitation fluid treatment, with or without norepinephrine.

Main Methods:

Eighteen piglets underwent controlled hemorrhage to a mean arterial pressure of 40 mmHg.
Hemorrhage was maintained for 30 minutes before randomization into control, lactated ringer (LR), or LR with norepinephrine (NA) groups.
Hemodynamic, biological, and ultrasound data were collected throughout the study.

Main Results:

GLS significantly increased during the hemorrhagic phase (from 25 mL/kg depletion).
GLS significantly decreased during the resuscitation phase (from 20 mL/kg fluid administration).
No significant differences in GLS variation were observed among the control, LR, and NA groups during any phase.

Conclusions:

In this HS piglet model, GLS exhibits preload dependence, increasing with hemorrhage and decreasing during resuscitation.
The study did not find significant differences in GLS changes based on fluid resuscitation strategy with or without norepinephrine.