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MARIO ONNIS, M.D., HARms B. SHUMACKER, JR., M.D., GUSTAVo BOUNOUS, M.D.
From the Department of Surgery and the Heart Research Center, Indiana University
School of Medicine, Indianapolis, Indiana
THE PRESENT study was undertaken in the 30-minute period of arterial occlusion
order to investigate systemic blood pres- and every five minutes during a 15-minute
sure and renal blood flow responses to period after release of the clamp.
acute clamping of the major abdominal Four groups of eight dogs each were
visceral arteries. studied. In the first the superior mesenteric
artery was occluded, in the second the
Materials and Methods celiac axis, in the third the hepatic artery,
Adult mongrel dogs varying in weight and in the fourth both inferior and superior
from 11.8 to 17.3 kilograms were used. mesenteric arteries and the celiac axis. In
They were anesthetized by the intravenous an additional group of four dogs thoraco-
injection of 5.0 per cent thiopental sodium. lumbar sympathectomy and splanchnicec-
An endotracheal tube was inserted and tomy were performed in two stages by a
oxygen was administered rhythmically by technic described previously.4 Approxi-
means of a mechanical respirator. Mean mately eight days later arterial pressure
arterial blood pressure was monitored by and renal blood flow were studied before,
a U-tube mercury manometer connected during, and after clamping of both mesen-
with a plastic catheter inserted into the teric arteries and the celiac axis.
aorta via a femoral artery. Temperature
was measured by a telethermometer placed Results
in the mid portion of the esophagus. Renal Clamping of the Superior Mesenteric
blood flow was determined by a direct Artery. In this group the mean arterial
method which has been described previ- blood pressure during the control period
ously.2 The arteries to be occluded were varied from 110 to 140 and averaged 124
dissected free using nonsterile technic. mm. Hg (Fig. 1). A mild increase in
After renal blood flow and arterial pressure arterial pressure occurred during the period
had been measured during a ten-minute of superior mesenteric arterial clamping in
control period, the arteries were clamped seven of the eight animals. Blood pressure
with a noncrushing arterial clamp. Renal remained essentially unchanged in the ex-
blood flow and systemic arterial pressure ceptional instance. On the average the
were measured every five minutes during arterial blood pressure rose 15 mm. Hg.
* Submitted for publication January 17, 1962. The blood pressure fell in every instance
Aided by PHS research grant (H-203 C5) when the clamp was removed from the
from the National Heart Instituite, National In- mesenteric artery. Renal blood flow values
stitutes of Health, Public Health Service, and
by grants from the American Heart Association during the control period ranged from 18.9
and James Whitcomb Riley Memorial Association. to 27.2 and averaged 21.9 cc./kg./min. A
56
Volume 157
Number 1
OCCLUSION OF VISCERAL ARTERIES 57
very slight increase in renal flow occurred
during the period of clamping in each ani-
mal. The average increase was little, only
approximately 10 per cent above the con-
trol values. Upon release of the clamp a E
130T
very slight decrease in the renal blood flow
was observed in six of the eight dogs. The 120-~~~~~~~~~~~~
1tR
renal flow was observed during the period 3
of clamping. (Fig. 4). During the control z
3.
M0
period the blood pressures ranged from 110
to 145 and averaged 125 mm. Hg. Increase
in blood pressure was observed during the
period of clamping in each instance. The
average blood pressuire increased to a level 0 5 10 15 20 25 30 5
approxil nately 30 m11. al)Ove the (onrl
t T I M E I N M I N U T E S
min ).
In Figure 6 the arterial blood pressure
and renal flow responses in the normally 1.12
arere ( et e
innervated and sympathectomized animals
are contrasted. Figure 7 summarizes the
5 10 15 20 25 30 5 10 15
In our studies the mean arterial blood pres- animal had normal innervation or had been
sure increased slightly when the superior subjected previously to bilateral thoraco-
mesenteric artery was occluded and more lumbar sympathectomy and splanchnicec-
so when the superior and inferior mesen- tomy. In contrast, the blood pressure fell
teric arteries and celiac axis were occluded. in those animals in which the celiac axis
This was true regardless of whether the was occluded and in those in which the
w
04
:
g4 z
0
0
Do
X,o-
0 5 10 15 20 25 30 5 10 15 0 5 10 15 20 25 30 5 10 15
T I ME IN MIN UT ES T I ME IN MIN UT ES
FIG. 6. Chart comparing responses in normal dogs and in those previously suibjected to thoraco-
lutmbar sympathectomy and splanchnicectomy (right) to clamping of celiac axis, superior aInd inferior
mesenteric arteries.
60 ONNIS. SHIU\l \CKER AND) BOU\OUS \AlIIl- 'ur-erv
Jaln tiat ! 1966
3 4:
0
W.
0 'in(.. 7. Chart siiiim-
z mrizing bloodl prc.ssurc
U (ABP antd (rle l floxv
)
_Z
44
lhepatic artery- alone as occlidecd. Beninati o.bservation x-mould lend xw eight to thle be-
andcl Ghigginio I haid noted a sliglht increase lief that the hypecrtensive reaction (1()es not
in systemic lbl1o0( pressure i1poi( occluision
) resuilt fIro mil xasocouistr-ictionl ani(d is b)cst ex-
recently Ilevmiiains andl hiis associates ald conse(quienice of a studden clhanige in the dis-
observed that the 1lood pressuire increasedl tribuition of blood flow aind reduction in
fromii 20 to 44 mim. Hg ( average 28 ) uipon effective xvascuilar- bed. Any rncal xvasocon-
clamllpinlg of the suiperior meseniteric artery. striction occtirriiig dutrinig C.ombincld meseii-
0
They foundi(I the inierease axeraged 130Mm. teric anil celiac clamping, is not felt re-
HIg xvleni the celiac axis an(1 superior an(I sponsible for elevation in blood piressture
iniferior meselnteric arteries Nx7ere occltu(led. sinc-e ympatlectomy al)olishes the formiiier
s