Neurochemical Circuits Subserving Fluid Balance and Baroreflex: A Role for Serotonin, Oxytocin, and Gonadal Steroids

Role of prolactin and gonadal steroids in regulation of oxytocin mRNA during lactation

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1995.269.1.e76 ◽

1995 ◽

Vol 269 (1) ◽

pp. E76-E84 ◽

Cited By ~ 7

Author(s):

R. Ghosh ◽

C. D. Sladek

Keyword(s):

Fluid Balance ◽

Plasma Renin ◽

Gonadal Steroids ◽

Plasma Prolactin ◽

Prolactin Release ◽

Stage Of Lactation ◽

Plasma Vasopressin ◽

Mrna Content ◽

Stimulation Of

The role of suckling, prolactin, and gonadal steroids in regulating hypothalamic oxytocin (OT) mRNA content during the 1st and 2nd wk of lactation was evaluated. On day 4 of lactation, OT mRNA content decreased in rats removed from their litter for 24 h compared with suckled controls. Either suckling (in the absence of prolactin release) or prolactin (in the absence of suckling) maintained OT mRNA content at this stage of lactation. In contrast, at day 11 of lactation, OT mRNA content remained unchanged in rats deprived of pups for 24 h. Ovariectomy did not compromise the ability of day 11 nonsuckled rats to maintain OT mRNA content; however, the increased water intake, plasma prolactin, plasma vasopressin (VP), plasma renin concentration, and hypothalamic VP mRNA content at day 11 compared with day 4 suggest a role for fluid balance in determining OT mRNA content during the 2nd wk of lactation. Thus, at day 4, suckling is a major determinant of OT mRNA content as a result of both direct activation of neuronal afferents to the OT neurons and stimulation of prolactin release. This is in contrast to day 11, when fluid balance may predominate in regulation of OT mRNA.

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Management of Intraoperative Fluid Balance and Blood Conservation Techniques in Adult Cardiac Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.2010111 ◽

2011 ◽

Vol 14 (1) ◽

pp. 28 ◽

Cited By ~ 10

Author(s):

George Vretzakis ◽

Athina Kleitsaki ◽

Diamanto Aretha ◽

Menelaos Karanikolas

Keyword(s):

Cardiac Surgery ◽

Blood Cell ◽

Fluid Balance ◽

Blood Product ◽

Blood Donation ◽

Autologous Blood ◽

Small Body ◽

Risk Indicators ◽

Blood Transfusions ◽

Blood Conservation

Blood transfusions are associated with adverse physiologic effects and increased cost, and therefore reduction of blood product use during surgery is a desirable goal for all patients. Cardiac surgery is a major consumer of donor blood products, especially when cardiopulmonary bypass (CPB) is used, because hematocrit drops precipitously during CPB due to blood loss and blood cell dilution. Advanced age, low preoperative red blood cell volume (preoperative anemia or small body size), preoperative antiplatelet or antithrombotic drugs, complex or re-operative procedures or emergency operations, and patient comorbidities were identified as important transfusion risk indicators in a report recently published by the Society of Cardiovascular Anesthesiologists. This report also identified several pre- and intraoperative interventions that may help reduce blood transfusions, including off-pump procedures, preoperative autologous blood donation, normovolemic hemodilution, and routine cell saver use.A multimodal approach to blood conservation, with highrisk patients receiving all available interventions, may help preserve vital organ perfusion and reduce blood product utilization. In addition, because positive intravenous fluid balance is a significant factor affecting hemodilution during cardiac surgery, especially when CPB is used, strategies aimed at limiting intraoperative fluid balance positiveness may also lead to reduced blood product utilization.This review discusses currently available techniques that can be used intraoperatively in an attempt to avoid or minimize fluid balance positiveness, to preserve the patient's own red blood cells, and to decrease blood product utilization during cardiac surgery.

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