Hemodynamics of pancreatic ischemia in cardiogenic shock in pigs

P. M. Reilly, Thomas J Toung, M. Miyachi, H. J. Schiller, G. B. Bulkley

Research output: Contribution to journalArticle

Abstract

Background and Aims: Previous studies have shown that the renin- angiotensin axis plays a pivotal role in vasoconstriction of the gastric, intestinal, and hepatic circulations during cardiogenic shock. The aim of this study was to evaluate the fundamental hemodynamic mechanism of pancreatic ischemia during cardiogenic shock induced by pericardial tamponade. Methods: Cardiogenic shock was induced by pericardial tamponade. Cardiac output (and total peripheral vascular resistance) was determined by thermodilution. Pancreatic blood flow (and vascular resistance) was determined with radiolabeled microspheres. Results: Graded increases in pericardial pressure produced corresponding decreases in cardiac output to 42% ± 1% and arterial pressure to 67% ± 3% of baseline and increases in total peripheral vascular resistance to 146% ± 5% of baseline. Pancreatic blood flow decreased disproportionately to 30% ± 3% of baseline, because of a disproportionate increase in pancreatic vascular resistance to 220% ± 19% of baseline. Previously confirmed blockade of the renin-angiotensin axis ablated this response, whereas confirmed blockade of the α-adrenergic system or vasopressin system had no significant effect. Without shock, central intravenous infusions of angiotensin II closely mimicked this selective vasoconstriction. Conclusions: Angiotensin-mediated selective pancreatic vasoconstriction results in significant pancreatic ischemia during cardiogenic shock.

Original languageEnglish (US)
Pages (from-to)938-945
Number of pages8
JournalGastroenterology
Volume113
Issue number3
DOIs
StatePublished - 1997
Externally publishedYes

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Cardiogenic Shock
Vascular Resistance
Swine
Ischemia
Hemodynamics
Angiotensins
Vasoconstriction
Cardiac Tamponade
Renin
Cardiac Output
Liver Circulation
Thermodilution
Vasopressins
Microspheres
Intravenous Infusions
Angiotensin II
Adrenergic Agents
Shock
Stomach
Arterial Pressure

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Hemodynamics of pancreatic ischemia in cardiogenic shock in pigs. / Reilly, P. M.; Toung, Thomas J; Miyachi, M.; Schiller, H. J.; Bulkley, G. B.

In: Gastroenterology, Vol. 113, No. 3, 1997, p. 938-945.

Research output: Contribution to journalArticle

Reilly, PM, Toung, TJ, Miyachi, M, Schiller, HJ & Bulkley, GB 1997, 'Hemodynamics of pancreatic ischemia in cardiogenic shock in pigs', Gastroenterology, vol. 113, no. 3, pp. 938-945. https://doi.org/10.1016/S0016-5085(97)70190-2
Reilly, P. M. ; Toung, Thomas J ; Miyachi, M. ; Schiller, H. J. ; Bulkley, G. B. / Hemodynamics of pancreatic ischemia in cardiogenic shock in pigs. In: Gastroenterology. 1997 ; Vol. 113, No. 3. pp. 938-945.
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