Key result
Hemorrhagic shock in rabbits decreased the potencies of phenylephrine- and histamine-induced contractions in isolated epigastric arteries by ~0.3 log units compared to prehemorrhage controls.
Vascular hyporeactivity during hemorrhagic shock involves long-lasting, intrinsic vascular smooth muscle desensitization induced by contractile stimuli.
Suggests intrinsic vascular desensitization in shock; leaves open translation to human vasopressor dosing.
The decompensatory phase of hemorrhage (shock) is caused by a poorly defined phenomenon termed vascular hyporeactivity (VHR). VHR may reflect an acute in vivo imbalance in levels of contractile and relaxant stimuli favoring net vascular smooth muscle (VSM) relaxation. Alternatively, VHR may be caused by intrinsic VSM desensitization of contraction resulting from prior exposure to high levels of stimuli that temporarily adjusts cell signaling systems. Net relaxation, but not desensitization, would be expected to resolve rapidly in an artery segment removed from the in vivo shock environment and examined in vitro in a fresh solution. Our aim was to 1) induce shock in rabbits and apply an in vitro mechanical analysis on muscular arteries isolated pre- and postshock to determine whether VHR involves intrinsic VSM desensitization, and 2) identify whether net VSM relaxation induced by nitric oxide and cyclic nucleotide-dependent protein kinase activation in vitro can be sustained for some time after relaxant stimulus washout. The potencies of phenylephrine- and histamine-induced contractions in in vitro epigastric artery removed from rabbits posthemorrhage were decreased by ∼0.3 log units compared with the control contralateral epigastric artery removed prehemorrhage. Moreover, a decrease in KCl-induced tonic, relative to phasic, tension of in vitro mesenteric artery correlated with the degree of shock severity as assessed by rates of lactate and K(+) accumulation. VSM desensitization was also caused by tyramine in vivo and PE in vitro, but not by relaxant agents in vitro. Together, these results support the hypothesis that VHR during hemorrhagic decompensation involves contractile stimulus-induced long-lasting, intrinsic VSM desensitization.
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Ratz et al. (2016) studied Hemorrhagic shock. Hemorrhagic shock vs. Prehemorrhage control contralateral artery was evaluated on Potencies of phenylephrine- and histamine-induced contractions. Hemorrhagic shock in rabbits decreased the potencies of phenylephrine- and histamine-induced contractions in isolated epigastric arteries by ~0.3 log units compared to prehemorrhage controls.
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