Monitoring of renal hemodynamics during acute hemorrhagic shock with doppler ultrasonic imaging: An experimental study / 解放军医学杂志

ABSTRACT

Objective To evaluate the value of color Doppler flow imaging (CDFI) and pulsed-wave Doppler (PWD) in monitoring renal hemodynamics in rabbits with acute hemorrhagic shock. Methods The experimental model of acute hemorrhagic shock was reproduced in 16 normal New Zealand white rabbits by controlled exsanguination which was divided into 4 different grades normal (100% MAP), mild (70% MAP), moderate (50% MAP), and severe (40% MAP). The right kidney of the experimental animal was examined by gray-scale ultrasound (2DUS), CDFI and PWD. The structure of the right kidney was observed with 2DUS. CDFI was used to monitor the change in right renal hemodynamics along with the progression of shock. The hemodynamic parameters of main renal artery (MRA), segmental renal artery (SRA) and interlobar renal artery (IRA) were measured by PWD, including the peak systolic velocity (Vmax), minimum diastolic velocity (Vmin) and resistive index (RI). Results The animal model of hemorrhagic shock was successfully reproduced in 16 healthy New Zealand rabbits, of which 14 rabbits survived at the end of the experiment, and 2 died of severe shock. The mean arterial pressure (MAP) declined, while the respiratory rate and heart rate increased as the circulation changed from normal to severe shock (Pmax and Vmin declined gradually, while RI intensity increased as the hemorrhagic shock progressed from minor to severe. There was statistically significant difference in RI intensity between different grades of shock (P<005). Conclusion CDFI and PWD can quantitatively assess the renal hemodynamics during acute hemorrhagic shock, so it can be used as a noninvasive monitoring tool in the diagnosis and treatment of hemorrhagic shock.