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Hemodynamic mechanisms in anaphylaxis.

S Enjeti, E R Bleecker, P L Smith

    Circulatory Shock
    |January 1, 1983
    PubMed
    Summary
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    Ascaris suum antigen and histamine cause shock by pooling blood in the periphery, but through different mechanisms. Aortic occlusion affects histamine shock more than antigen shock, indicating distinct circulatory responses.

    Area of Science:

    • Cardiovascular Physiology
    • Immunology
    • Pharmacology

    Background:

    • Ascaris suum antigen and histamine induce shock-like states with reduced cardiac output and systemic arterial pressure.
    • Peripheral blood pooling is implicated in the circulatory collapse observed in these models.

    Purpose of the Study:

    • To investigate the distinct mechanisms of peripheral blood pooling in Ascaris suum antigen-induced shock versus histamine-induced shock.
    • To differentiate the roles of peripheral pooling and myocardial function in these shock states.

    Main Methods:

    • Intravenous administration of Ascaris suum antigen (1 mg) and histamine (5 mg) to anesthetized, mechanically ventilated dogs.
    • Constant venous return maintained using an external pump reservoir system.
    • Splanchnic arterial inflow occlusion via descending thoracic aorta clamping.

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    Main Results:

    • Both antigen and histamine caused significant reductions in cardiac output and systemic arterial pressure, with peripheral pooling indicated by decreased reservoir blood volume.
    • Histamine shock: Cardiac output restored to control levels upon aortic occlusion.
    • Antigen shock: Cardiac output remained unaffected by aortic occlusion, despite similar circulatory failure magnitude.
    • Left atrial pressure remained stable in both shock states when venous return was constant.

    Conclusions:

    • The differential response to aortic occlusion suggests distinct mechanisms of peripheral blood pooling in antigen and histamine shock.
    • Intrinsic myocardial dysfunction is unlikely to be a primary cause of circulatory failure in either shock state studied.
    • Findings highlight the importance of understanding specific pathophysiological pathways in different types of shock.