ATP-MgCl2 restores renal microcirculation following trauma and severe hemorrhage.
Although ATP-MgCl2 enhances the recovery of renal function after ischemia and reperfusion, it is not known whether this agent has any beneficial effects on renal microcirculation and function in a nonheparinized model of trauma and severe hemorrhage. To study this, a midline laparotomy was performed (i.e., trauma induced) and the rats were bled to and maintained at a mean arterial pressure of 40 mmHg (1 mmHg = 133.32 Pa) until 40% of the maximum shed blood volume was returned in the form of Ringer's lactate (RL) solution. Animals were then resuscitated with 4 times the volume of the shed blood in the form of RL. ATP-MgCl2, 50 mumol/kg body weight, or an equivalent volume of saline, was infused intravenously during and following resuscitation. Renal microcirculation was examined by using colloidal carbon infusion and laser Doppler flow-metry. Glomerular filtration rate (GFR) was assessed with [3H]inulin clearance and cardiac output (CO) was determined by dye dilution technique. The results indicate that the depressed renal microcirculation following hemorrhage and resuscitation was restored by ATP-MgCl2 treatment. GFR was significantly higher in ATP-MgCl2-treated than saline-treated rats. ATP-MgCl2 also increased urine output, restored the decreased CO, and prevented the occurrence of renal edema after hemorrhage and resuscitation. Thus, ATP-MgCl2 appears to be a useful adjunct to crystalloid resuscitation following trauma and severe hemorrhagic shock even in the absence of blood resuscitation.
Wang
P
P
Department of Surgery, Michigan State University, East Lansing 48824.
Zhou
M
M
Rana
M W
MW
Singh
G
G
Ba
Z F
ZF
Ayala
A
A
Chaudry
I H
IH
D000255:Adenosine Triphosphate / Q000494:pharmacology*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D001834:Body Water / Q000187:drug effects / Q000378:metabolism; D002302:Cardiac Output / Q000187:drug effects; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006470:Hemorrhage / Q000188:drug therapy / Q000503:physiopathology*; D007668:Kidney / Q000293:injuries* / Q000503:physiopathology; D007672:Kidney Cortex / Q000098:blood supply; D015636:Magnesium Chloride / Q000494:pharmacology*; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D051381:Rats; D011919:Rats, Inbred Strains; D012039:Regional Blood Flow / Q000187:drug effects; D012079:Renal Circulation / Q000187:drug effects*
D015636:Magnesium Chloride; D000255:Adenosine Triphosphate