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The Annals of Thoracic Surgery, Vol 57, 974-980, Copyright © 1994 by The Society of Thoracic Surgeons
RS Wolfer, GG Bishop, MG Burdett, K Shigemi, JP Freeman, MJ Krasna, JS McLaughlin and MJ Brunner
We investigated the effects of increases in central venous pressure (CVP)
and carotid baroreceptor-induced vasodilation on the rate of extravascular
fluid uptake during cardiopulmonary bypass in normotensive and Goldblatt
hypertensive dogs. Carotid sinus baroreceptors were selectively perfused to
control the level of vasodilation. Central venous pressure was controlled
by changing the height of the venous outflow cannula. Extravascular fluid
uptake was determined from the rate of change in reservoir volume. After 3
hours of bypass, total fluid accumulation was 56.11 +/- 14.16 mL/kg in
normotensive dogs, significantly less than in hypertensive dogs (110.90 +/-
23.20 mL/kg) (p < 0.05). Raising CVP from 1 to 5 mm Hg increased the
rate of extravascular fluid uptake in both normotensive (from 0.05 +/- 0.25
to 0.85 +/- 0.22 mL.kg-1.min-1; p < 0.05) and hypertensive dogs (from
0.68 +/- 0.28 to 2.57 +/- 0.46 mL.kg-1.min-1; p < 0.01)). At a constant
CVP, baroreceptor-induced vasodilation increased the rate of extravascular
fluid uptake in normotensive (from 0.25 +/- .15 to 0.81 +/- .22
mL.kg-1.min-1) and in hypertensive dogs (from 0.84 +/- .12 to 1.72 +/- .32
mL.kg-1.min-1; p < 0.05). Hypertensive dogs were more sensitive to
changes in CVP and to baroreceptor-induced vasodilation. The results of
this study imply that elevations in CVP or the use of vasodilators may lead
to increased extravascular fluid uptake during bypass; this effect may be
exacerbated in the hypertensive state.
ARTICLES
Extravascular fluid uptake during cardiopulmonary bypass in hypertensive dogs
Department of Surgery, University of Maryland at Baltimore 21201.
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