Rheographic View of the Change in the Renal Blood Flow in Acute Hemorrhage

Rheogram으로 본 실혈시 신장혈액유통 변화

Studies were undertaken on the changes in the renal blood flow by relating them with the alterations in the amplitudes in the rheogram of rabbits. The changing pattern of the electrical conductivity was recorded by means of the needle electrodes inserted into the kidney and the surrounding aluminium foil which was grounded. The Impedance Rheograph manufactured by the Narco Company was used. The small artifact which persisted after ligation of the renal vessels was subtracted from the value obtained in each pulsatile wave in the rheogram. The animals were nembutalized intravenously, 30 mg/kg. A plastic canule was inserted into the carotid artery and the arterial blood pressure was monitored continuously with the pressure transducer connected to the physiograph. Stepwise bleedings were performed on the animal. The first bleeding was between 13 to 18 ml in the amount, and it was folowed by consecutive hemorrhages, 5 or 10 ml each time. The total amount of bleeding was summed as much as 1.5-2% of the body weight. Two minutes fter each bleeding th arterial blood pressure, ECG and the rheogram were taken. That was the necessary time to obtain the stabilized picture of each parameter. After closing the bleeding process, the shed blood was retransfused into the animal and the response in the renal blood flow was observed as well as the arterial blood pressure. Particularly the presence or absence of the autoregulatory mechanism in the situation of the hemorrhage was also studied. The results obtained were as follows: 1. In 7 cases out of 22, that was about one third of the total number of experiments, the autoregulatory mechanism of the renal blood flow persisted even in acute hemorrhage, and the decreases in the renal blood flow were less than 10% of the control values even when the arterial blood pressure dropped to 66-87% of the original value obtained before the bleeding. 2. Because of the stepwise bleeding the exact blood pressure at which the renal blood flow reduced as much as one third of the control value could not be obtained. However, the results revealed that the approximate pressure, expressed as percentage of the control value, was 50-60% in 3 cases, 61-70% in 4 cases and 71-80% in 8 cases. In one case the decrease in the renal blood flow exceeded one third of the control value before the pressure dropped to 80% of the control. 3. In 19 cases the decreases in the renal blood flow exceeded one half of the control values by hemorrhage. Then the arterial blood pressure revealed less than 40% of the control value in 6-cases. In 2 cases the pressure was 51-60% of the control pressure. In 5 cases the range of bleed pressure was 61-70%, and in e remaining 6 cases the pressure ranged from 71 to 80% of e control value. 4. Out of 15 cases of retransfusion after definite decreases in the renal blood flow loller·ing the hemorrhage, 9 cases restored their renal blood flow. On the contrary 6 cases showed low values even when the shed blood was retransfused. 5. Theories concerning the mechanism of the autoregulation of the renal blood flow were reviewed for the purpose of explanation of the results obtained. However, there are much to be done before greater satisfaction