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Larry L. Shears
Ronald C. Hill
Robert A. Gustafson
Geoffrey M. Graeber
Gordon F. Murray
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Ann Thorac Surg 1993;55:834-837
© 1993 The Society of Thoracic Surgeons

Articles

Myocardial performance after contusion with concurrent hypovolemia

Larry L. Shears, MD, Ronald C. Hill, MD*, Gregory A. Timberlake, MD, Kathryn C. Beamer, MS, Robert A. Gustafson, MD, Geoffrey M. Graeber, MD, Gordon F. Murray, MD

Department of Surgery, West Virginia University School of Medicine, Morganlown, West Virginia USA

* Address reprint requests to Dr Hill, Department of Surgery, West Virginia University School of Medicine. Rm 4060 Health Sciences Center North, PO Box 9238, Morgantown, WV 26506-9238.

Myocardial contusion may present as a benign nonclinical event or a life-threatening emergency. Although cardiac output is recognized to be decreased with major contusion, the contribution of hypovolcmic shock io myocardial dysfunction is unclear. This study was designed to evaluate the relationship between myocardial contusion and hypovolemic shock. After Sprague-Dawley rats were anesthetized, contusions were administered at either 80 psi or 120 psi. Half of each group then underwent hypovolemic shock. After 24 hours of recovery, cardiac hemodynamics were studied in each subgroup using the Neely-Langendorff apparatus. Isoenzymes and histology were evaluated as well. The data showed that rats undergoing hypovolemic shock in each subgroup had a significant decrease in cardiac output when compared with their controls. This decrease was more pronounced in the 120-psi group. Cardiac isoenzyme levels were elevated in all groups. Microscopic evaluations showed contusion in the controls and necrosis in the shuck groups. Patients whose injuries are compatible with myocardial contusion and hypovolemic shock should be resuscitated quickly and evaluated for myocardial dysfunction secondary to infarction.




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Copyright © 1993 by The Society of Thoracic Surgeons.