The Contribution of Splanchnic Pooling to Endotoxin Shock in the Dog

• Published in: Circulation research 1977-01, Vol.41 (4), p.467-472
• Main Authors: GUNTHEROTH, WARREN G, KAWABORI, ISAMU
• Format: Article
• Language: English
• ISSN: 0009-7330; 1524-4571

To assess the role of splanchnic pooling in the first 4 hours of endotoxin shock, we measured pressures and flows and injected radiographic contrast material in 56 dogs, while intervening with portacaval shunting, ligation of the portal vein, and splenectomy because these interventions had previously been reported as beneficial. Compared to the intact dogs, those with portacaval shunts had a less precipitous fall in cardiac output and blood pressure following endotoxin, but by 30 minutes and thereafter there were no sbstantial differences in the hemodynamics except for a lower portal vein pressure. In addition, there was a greater mortality in the shunted dogs. Ligation of the portal vein in the shunted dogs produced no important differences. Splenectomy alone produced no difference in the intact dogs except for a mild reduction in the peak portal vein pressure after endotoxin, but splenectomy in dogs with shunt and portal ligation was quickly fatal after endotoxin. Radiographic contrast studies demonstrated almost complete cessation of portal and hepatic vein flow 5 minutes after endotoxin, with recovery by 1 hour. The course of systemic hemodynamics during endotoxin shock was not altered by portacaval shunting, with or without ligation of the portal vein, and the mortality actually was increased by those interventions. In these experiments, there was no evidence of intravascular pooling (as opposed to extravasation) except for early transient hepatic trapping, which appeared to result from increased venomotor activity.