Cardiovascular changes during controlled blood loss and replacement

Kirwan, T.; Scurr, C. F.; Smith, G.B.

doi:10.1111/j.1365-2044.1981.tb08700.x

Cited by 6 publications

(4 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…) may affect diastolic filling by attenuating CBV (Kirwan et al. ). Experimental support for this was provided by Grover and colleagues who demonstrated that inspiratory CO 2 supplementation during hypoxic exposure prevents both the PV contraction and the reduction in SV (Grover et al.…”

Section: Discussionmentioning

confidence: 99%

Hypovolemia explains the reduced stroke volume at altitude

et al. 2013

View full text Add to dashboard Cite

During acute altitude exposure tachycardia increases cardiac output (Q) thus preserving systemic O2 delivery. Within days of acclimatization, however, Q normalizes following an unexplained reduction in stroke volume (SV). To investigate whether the altitude-mediated reduction in plasma volume (PV) and hence central blood volume (CBV) is the underlying mechanism we increased/decreased CBV by means of passive whole body head-down (HDT) and head-up (HUT) tilting in seven lowlanders at sea level (SL) and after 25/26 days of residence at 3454 m. Prior to the experiment on day 26, PV was normalized by infusions of a PV expander. Cardiovascular responses to whole body tilting were monitored by pulse contour analysis. After 25/26 days at 3454 m PV and blood volume decreased by 9 ± 4% and 6 ± 2%, respectively (P < 0.001 for both). SV was reduced compared to SL for each HUT angle (P < 0.0005). However, the expected increase in SV from HUT to HDT persisted and ended in the same plateau as at SL, albeit this was shifted 18 ± 20° toward HDT (P = 0.019). PV expansion restored SV to SL during HUT and to an ∼8% higher level during HDT (P = 0.003). The parallel increase in SV from HUT to HDT at altitude and SL to a similar plateau demonstrates an unchanged dependence of SV on CBV, indicating that the reduced SV during HUT was related to an attenuated CBV for a given tilt angle. Restoration of SV by PV expansion rules out a significant contribution of other mechanisms, supporting that resting SV at altitude becomes reduced due to a hypovolemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Hypovolemia explains the reduced stroke volume at altitude

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Blood pressure (BP) has been found to increase (Kuchel, Avorn, Reed & Fields, 1992), decrease (Kirwan, Chir, Scurr & Brindle Smith, 1981) or not to change at all (Abraham et al, 1992) after a blood loss of 250-500 ml., and information on peripheral flow and resistance during and after phlebotomy are even more sparse. Besides, the question of whether the hemodynamic response to phlebotomy depends directly on For reprints write to: Edoardo Casiglia, M.D., Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani, 2 -35128 Padova, Italy.…”

Section: Hemodynamics Following Real and Hypnosis-simulated Phlebotomymentioning

confidence: 98%

Hemodynamics following Real and Hypnosis-Simulated Phlebotomy

Casíglia

Mazza

Ginocchio

et al. 1997

American Journal of Clinical Hypnosis

View full text Add to dashboard Cite

Forearm arterial flow was measured in 22 healthy first-time blood donors during a 300-ml. blood letting and during the subsequent recovery. Blood pressure (BP) was also taken simultaneously and forearm peripheral resistance calculated. Following a transient BP and flow increase due to tachycardia related to needle insertion, both systolic BP and flow progressively and significantly decreased, while resistance increased. In a further 22 sex- and aged-matched highly hypnotizable subjects, blood donation was simulated by means of verbal hypnotic suggestions. The BP, flow and resistance curves were similar to those obtained with the real blood letting, without any between-subject difference or group/time interaction. Mere hypnosis without suggestion of phlebotomy and the simple bed resting did not produce any effect. These results indicate that the hemodynamic changes observed during and after a blood loss are partly due to mental involvement rather than merely to the hydraulic effects of the removal of blood.

show abstract

“…Sometimes the phlebotomy-induced BP fall lasts 24 hours or more2,11) (even 4 weeks in the experience of Zidek et al,12) who hypothesize that phlebotomy can be used in addition to drug treatment in resistant essential hypertension), sometimes it is transitory.4,11, 25) The long-term effects of blood donation on BP are essentially unknown and the question of whether regular blood letting implies higher, lower or unchanged BP values in blood donors remains unanswered. In our experience, regularly repeated blood donation was accompanied by a reduction in systolic BP.…”

Section: Discussionmentioning

confidence: 99%