acid-phosphatase and Shock--Cardiogenic

Topics: Acid Phosphatase; Aged; Biomarkers; Humans; Male; Myocardial Infarction; Prostate-Specific Antigen; Protein Tyrosine Phosphatases; Shock, Cardiogenic

Assisted circulation in severe cardiogenic shock was evaluated using a reservoir and a single pump without an oxygenator in 88 dogs. Study groups included: no treatment, substrates only (cysteine, ribose), nitroprusside, left ventricular (LV) + right atrial (RA) bypass + substrates, LV + RA bypass, left atrial (LA) + RA bypass, LA bypass, LV bypass, LV + RA + fluosol. Metabolic studies of O2 consumption, acid and alkaline phosphatase, lactate, creatine phosphokinase (CPK), myocardial depressant factor (MDF), and tissue adenosine triphosphate (ATP) were done in the course of 4-hour treatment periods followed by 2-hour observation periods. Best survival at 4-hour and 6-hour levels were achieved in LV + RA bypass. Cysteine and ribose reduced survival when added to the pump supported (LV + RA bypass) group. Cysteine/ribose improved survival over the no treatment group. O2 consumption increased significantly in the groups with best survival but remained unchanged from control or shock levels when cysteine/ribose were added. Unusually high levels of CPK, acid and alkaline phosphatase, and MDF occurred in both groups receiving cysteine/ribose, indicating significant organ damage correlating with poor survival. Lactate levels were less predictive. Heart tissue ATP levels were higher in groups with good survival. Liver ATP levels were lower in high survival groups. Lung ATP did not differ between groups.

Topics: Acid Phosphatase; Alkaline Phosphatase; Animals; Assisted Circulation; Blood Substitutes; Creatine Kinase; Cysteine; Dogs; Fluorocarbons; Nitroprusside; Oxygen Consumption; Ribose; Shock, Cardiogenic

The activity of some organ specific enzymes of the liver subcellular structures in the blood serum was examined in 56 patients with cardiogenic shock. The correlation between the gravity of clinical signs of cardiogenic shock and blood enzyme degree was revealed. It was concluded that biochemical criteria could be used in the diagnosis of irreversible changes in the liver in cardiogenic shock.

Topics: Acid Phosphatase; Aged; Cholinesterases; Female; Fructose-Bisphosphate Aldolase; Glutamate Dehydrogenase; Humans; Liver; Male; Middle Aged; Myocardial Infarction; Organ Specificity; Shock, Cardiogenic

The effect of corticosteroids on cellular resistance in shock was studied by serial measurement of the serum concentration of the lysosomal enzyme acid phosphatase in untreated and steroid dogs subjected to hemorrhagic, endotoxin and cardiogenic shock. In each shock category, elevation in serum acid phosphatase was significantly less in steroid treated dogs as compared to untreated animals at corresponding time intervals. This difference was most apparent in endotoxin shock, next in hemorrhagic shock and least in cardiogenic shock. Steroid treatment also reduced the serum lactate increment in hemorrhagic and cardiogenic shock and delayed or reduced the onset and severity of the occurring acidosis, an apparent reflection of the ability of steroids to promote increased tissue perfusion. In addition, steroid treatment increased or prolonged survival in all three shock groups. By showing that glucocorticoids affect a reduction in the release of the lysosomal enzyme acid phosphatase during shock, the study offers direct evidence that steroids enhance cellular resistance to shock stress in the dog. Whether this salutary effect is due solely to the ability of steroids to stabilize cellular membranes or is in part secondary to promoting improved tissue hemodynamics could not be established. The interpretation and clinical application of these results must take into account the possibility of a species specific response.

Topics: Acid Phosphatase; Acidosis; Animals; Blood Transfusion, Autologous; Cell Membrane Permeability; Coronary Vessels; Endotoxins; Hemoglobinometry; Lactates; Ligation; Lysosomes; Methylprednisolone; Pyruvates; Shock, Cardiogenic; Shock, Hemorrhagic; Shock, Septic; Time Factors

Topics: Acid Phosphatase; Animals; Colorimetry; Dogs; Lymph; Lysosomes; Methylprednisolone; Shock; Shock, Cardiogenic; Shock, Hemorrhagic; Shock, Septic; Thoracic Duct