THE EFFECT OF HEATED BLOOD ON THE MICROCİRCULATION AND ITS TREATMENT WITH STEROİD.
AN EXPERIMENTAL INVESTIGATİON
İn this experimental research study, the effect of heated blood on the microcircuiation and its treatment with steroid were investi- gated. This study was performed on the microcircuiation m the mesentery of dogs. The changes in the microcircuiation were obser- ved on misroscope under optical system for 30 minute-periods.
75 healthy mongrol dogs (8-18 Kg.) of both seXes were used and they were divided into the three experimental groups. The group A was for control, the group B was for heated blood and the group C was for heated bloood and the steroid. Photographic recording was made immidiately after, 5, 10, 15, 20, 25 and 30 minutes foilovving infusion and the microscopic îmage was recorded on the photograp
hic and cine film.
Group A (contro!) consîsted of the infusion of blood which had not been heated and no important changes İn microcircuiation had been observed.
Group B consisted of blood heated to 58°C for 60 seconds and than cooled to 37°C before infusion. Significant changes mentioned below were observed on the microvessels and the microcircuiation in this group :
1 — Sticking of leukocytes and margination of leukoçytes to endotheiilal surface.
2 — Swe!ling and thickening of the endothelial wal.
3 — Aggregatîon, clumping, sluding and spherical shapening of erythrocytes.
4 — Slow-down of blood flow in the microcircuiation.
5 — Extravasation and emigration of leukocytes, plasma and the erytrocytes around of the microvessels.
6 — Constriction and dilatation of arterioies and venules.
7 — Fail in mean arterial pressure.
Group, C consisted of the steroid administration (Solu-Mearol, 30 mg/per dog) immidiately after infusion of the heated blood.
Although, above mentioned changes were occured when the heated
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blood was infused, ali pathologic changes almost disappeared and/
or lessened immidiately after îhe administratîon of the steroid.
As a result, it was hypothesized that ali changes (Microvascuiar disturbance involving structure and function) in the group B reveal and constitute the majör mechanism in the patho-physiology of burns. They are responsible for local tissue derangement and dest- ruction in burned areas. İt is important to emphasize that they are olso responsible for the systemic circulatory failure occuring in severe burns.
Minumum changes observed in the group C revealed the signi- ficant effect of the steroid on the microcirculation.
K A Y N A K L A R
1. ZVVEIFACH, B.W.: M îcrocirculatory Aspects of Tissue İnjury, Ann. N.Y. Acad.
Sci. 116: 831-838, 1964.
2. GUEST, M.M., BOND, T.P.: Refease of Thromboplastin after Thermal fnjury, Ann. N.Y. Acad Sci. 150: 528-536, 1968.
3. GUEST, M.M.: Microcirculation: Capiitary Dynamics, Lymph Circulation and Local Vascular Regulation, Medical Physîology and Biophysics Syllarbus, Galveston-Texes, 1977, Vol 3: 275-305.
4. MASSIHA, H., MONAFO, W.W.: Dermal Ischemia in Thermal İnjury: The Im- portance of Venous Occlusion, J, Trauma 14: 705-762, 1974.
5. GUEST, M.M'., BOND, T.P.: High Speed photograhp in the Study of the M icrocirculation, Bibi. Anat. 11: 211-218, 1973.
6. ATHERTON, A., BORN, G.V.R.: Ûuantitative Investigations of The Adhesiveness of Circulating Polymorphonuclear Leucocytes to Blood Vesse) Walls, J.Physiol.
22: 447, 1972.
7. MAYROVİTZ, H.N., TUMA, R.F., VİEDEMAN, M.P.: Relatıonship Between Microvascuiar Blood Velociity ,and Pressure Oistribution, Am. J.Physiol. 232:
400-405, 1977.
8. GUEST, M.M., BOND, T.P., CRAVVFIRD, M.A.: A Possible Role of leucocytes in Hemostasis, Bibi, Anat. 12: 131-137, 1973.
9. BRANEMARK, P.I., BREİNE, U.. UR'BASCHEK, J.B.: Microvascuiar Pathopysio- logy of Burned Tissue, Ann. N.Y. Acad. Sci. 150: 474-494, 1968.
10. CLARK, E.R., Clark, E.L.: Observations an Changes İn Blood Vascular Endot- helîum in The Living Ani mal, Am. J. Anat. 57: 385-435, 1935.
11. MAYROVİTZ, H.N., VİEDEMAN, M.P., TUMA, R.F.: iFactor Influencing Leucocyte Adherence in Microvessels, Throm. Haemostassi 38: 823-830, 1977.
56
12. STEAVVART, G.J., RITCHIE, W .G .M „ LYNCH, P.R.: Venous Endothelial Damage Produced by Massive Sticking and Emigretion of Leukocytes, Am. J. Path. 74:
507-521, 1974.
13. KARLE, H., HANSEN, N.E.: Changes in the Red Celi Membrane Induced by a Small Rise in Temperature, Scand. J. Cfin. Lab. invest. 26: 169-174, 1970.
14. MAJNO, G „ STEPHEN, M., LEVENTHEL, M.: Endothelial Contraction Induced by Histamintype Media.tor, J. 'Celi Biol. 42: 647-762, 1969.
15. LOEBL, E.C., BAXTER, C.,R., CURRERİ, P.W.: The Mechanism of Erythrocyte
■Destruction in the Early 'Post-Burned Period, Ann. .Surg. 178: 681-686, 1973.
16. PONDER, E.,: Shape and Shape Transfer m ati on of Heated Human Red Cells, J. Exp. Biol. 26: 35-45, 1949.
17. ROBB, H.J.: Dynamics o f the M icrocirculation Dur'inıg a .'Burn, Arch. Surg, 94:
776-779, 1967.
18. CHİEN, S., USAMI, S., DELLENBACK, 'R.J., GREGERSEN, M.I.: B'lood Viscosity Influence of Erythrocyte Aggregation Science 157: 829-831, 1967.
19. ATHERTON, A., BORN, 'G.V.R.: Relationship Between The Velocity of Roliing Granülocytes and that of The Blood Flow in Venules, J. Physiol. 233: 157-165, 1973.
20. WELLS, F.R., MILES, A.A.: Site of the Vascular Response the Thermal Injury.
Nature 200': 1015-1016, 1963.
21. HADDY, FJ,: Effect of Hlstamine on Small land Large Vessel Pressures lin the Dog Foreleg, Am. J. Physiol, 198:: 161 -168, 1960.
22. ARTURSON, G., HAMBERG, M., JONSSON, C.E.: Prostoglandins :in Human Burn Blister Fluid, Açta Physiol. Scand. 87: 270-276, 1973.
23. CRUNK.HORN, P., WliLLlS, A.L.: .Cutaneus Reactions to Intradermal Prostagian- dins, Brit. J. Pharmac. 41: 49-56, 1971.
24. KALEY, G., VVEINER, R.: Prostaglandin El: A Potentiai Mediaton of the Inflammatory Response, Ann. :N.Y. Acad. Sci. 180: 338-348, 1971.
25. LILLEHEI, R.C., R.C., L0NGERBEAM, J.K., BLOCH, J.H., MANAX, W.G.: The Modern Treatment of Shock Based on Physiologic Prİnoiples, Clin. Pharmocol.
Ther. 5: 63-101, 1964.
26. SCHUMER, W.: Steroids in the Treatment of Climcal Septic Shock, Ann. Surg.
84: 33-341, 1976.
27. ZURIER, R.B., VVEİSSMANN, G.: Anti-ılmmunologic and Anti-inflamatory Effects of Stroid Therapy, Azarnoff, D.L., Steroid Therapy, Philadeiphfa, W.B. Saunders Co., P: 223-235, 1975.
28. HAYNES, R.C.: Biochemical Mechanisms of 'Steroid 'Effects, Azarnoff, D.L., Steroid Therapy, Philadelphia-London-Toronto, W..B. Saunders Com. P: 15-24, 1975.
29. ROBSON, M.C., DELBECCARO, E.J., iHEGGERS, J.P.: The Effect Prostagian- dıins on the Dermal Microcirculation A fter Burning and its Prevention by Specifis Pharmacologic Agents, Junior Classîf.ication Scholarship Contest, P:
1-29, 1978,
