Effects of angiotensin II receptor antagonist on intestinal mucosal oxygenation during canine isovolemic hemodilution with hydroxyethyl starch

• Published in: Masui. The Japanese journal of anesthesiology Vol. 52; no. 6; p. 603
• Main Author: Hayashi, Kenji
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.06.2003
• Subjects: Angiotensin Receptor Antagonists; Animals; Blood Volume; Dogs; Hemodilution; Hydroxyethyl Starch Derivatives - administration & dosage; Intestinal Mucosa - metabolism; Intestines - blood supply; Oxygen - metabolism; Oxygen Consumption; Regional Blood Flow
• ISSN: 0021-4892

Although isovolemic hemodilution can be used clinically to reduce the need for blood transfusion, the critical hemoglobin level and severe indequacy of tissue oxygenation induced by hemodilution remain unknown. Anesthetized dogs were submitted to graded hemodilution (20% and 40% blood volume reductions of estimated circulating blood volume) replaced with 10% hydroxyethyl starch. The effect of angiotensin II receptor (AT-II) antagonist, candesartan, on the intestinal mucosal oxygenation was assessed by tonometric method. The splanchnic blood flow, measured by transit-time flow meters, and intestinal mucosal oxygenation were maintained well during 20% blood volume reduction without AT-II antagonist. By severe blood volume reduction, however, inadequate oxygenation was observed without, but not with AT-II antagonist. These results suggest the protective effect of AT-II antagonist on intestinal perfusion during severe isovolemic hemodilution. Further investigation will be needed in patients undergoing major surgery with large anticipated blood loss.