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UC San Diego UC San Diego Electronic Theses and Dissertations Title Effects of viscogenic plasma expander on cardiac and vascular function Permalink https://escholarship.org/uc/item/8hh6r2dp Author Chatpun, Surapong Publication Date 2010 Peer reviewed|Thesis/dissertation eScholarship.org Powered by the California Digital Library University of California UNIVERSITY OF CALIFORNIA, SAN DIEGO Effects of Viscogenic Plasma Expander on Cardiac and Vascular Function A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Bioengineering by Surapong Chatpun Committee in charge: Professor Pedro Cabrales, Chair Professor Marcos Intaglietta Professor Paul Johnson Professor Kirk Peterson Professor Geert Schmid-SchÖenbein Professor Daniel Tartakovsky 2010 Copyright Surapong Chatpun, 2010 All rights reserved. The Dissertation of Surapong Chatpun is approved, and it is acceptable in quality and form for publication on microfilm and electronically: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Chair University of California, San Diego 2010 iii DEDICATION To my Parents and Family iv TABLE OF CONTENTS Signature Page…………………………………………………………………………. iii Dedication……………………………………………………………………………… iv Table of Contents……………………………………………………………………… v List of Figures………………………………………………………………………….. ix List of Tables…………………………………………………………………………... xiii Acknowledgements…………………………………………………………………….. xiv Vita…………………………………………………………………………………..... xvii Abstract of the Dissertation.....................……………………………………………… xix Chapter 1 General Introduction........................................................................................ 1 Viscosity of Plasma Expander …………………………………………………… 1 Cardiac Function Assessment ……………………………………………………. 3 Shear Stress-induced Nitric Oxide and Vascular Mechanotransduction ……........ 5 Aims and Approaches ............................................................................................. 8 Organization of the text .......................................................................................... 10 References................................................................................................................ 12 Chapter 2 The Assessment of Left Ventricular Cardiac Function in the Sodium Pentobarbital-Anesthetized Hemorrhagic Shock Model ................................................. 17 Abstract ................................................................................................................ 17 Introduction .......................................................................................................... 18 Materials and Methods.......................................................................................... 19 Results................................................................................................................... 25 Discussions .......................................................................................................... 38 v References............................................................................................................ 43 Chapter 3 The Effects of Viscogenic Plasma Expanders on Cardiac Function: The Study in Moderate Hemorrhagic Shock-Resuscitation Model................................................... 45 Abstract ............................................................................................................... 45 Introduction ......................................................................................................... 47 Materials and Methods......................................................................................... 48 Results.................................................................................................................. 56 Discussions........................................................................................................... 70 Acknowledgements ............................................................................................. 73 References............................................................................................................. 75 Chapter 4 The Effects of Viscogenic Plasma Expanders on Cardiac Function: The Study in Acute Isovolemic Hemodilution Model...................................................................... 77 Abstract ............................................................................................................... 77 Introduction ......................................................................................................... 79 Materials and Methods......................................................................................... 81 Results.................................................................................................................. 87 Discussions........................................................................................................... 96 Acknowledgements............................................................................................. 100 References........................................................................................................... 101 Chapter 5 The Increased Vascular Nitric Oxide Enhances Ventricular Function in Acute Isovolemic Hemodilution with Low Viscogenic Plasma Expander............................... 104 Abstract............................................................................................................... 104 Introduction......................................................................................................... 106 vi Materials and Methods........................................................................................ 107 Results................................................................................................................. 113 Discussions......................................................................................................... 125 Acknowledgements............................................................................................. 128 References............................................................................................................129 Chapter 6 The Contribution of Endothelial Glycocalyx Integrity in the Interaction with Viscogenic Plasma Expanders and its Effects on Cardiac and Vascular Function during Acute Isovolemic Hemodilution .................................................................................... 133 Abstract............................................................................................................... 133 Introduction......................................................................................................... 135 Materials and Methods........................................................................................ 137 Results................................................................................................................. 145 Discussions......................................................................................................... 157 Acknowledgements............................................................................................. 161 References............................................................................................................162 Chapter 7 Conclusions.................................................................................................... 165 The effects of viscogenic plasma expanders on cardiac function ...................... 165 The contribution of shear stress-induced nitric oxide on cardiac and vascular function............................................................................................................... 167 A role of interaction between viscogenic plasma expanders and vascular endothelial surface on cardiac and vascular function......................................... 168 Strengths of this study ........................................................................................ 169 Weaknesses and limitations of this study .......................................................... 169 vii Future directions................................................................................................. 170 Appendix I Mathematical Relationship between Stroke Work and Fluid Viscosity..... 171 Appendix II Left Ventricular Blood Volume Estimation.............................................. 173 viii LIST OF FIGURES Figure 2.1: Linear regression of blood calibration from blood conductance to actual volume in each known-volume cylindrical cuvette.................................... 23 Figure 2.2: Schematic diagram of fixed volume-hemorrhagic shock protocol............ 24 Figure 2.3: Mean arterial pressure measured at baseline and during hemorrhagic shock............................................................................................................ 28 Figure 2.4: Heart rate measured at baseline and during hemorrhagic shock ................ 29 Figure 2.5: Left ventricular systolic function indexes derived by PV conductance catheter....................................................................................................... 33 Figure 2.6: Approximated left