ATP-MgCl2 restores the depressed cardiac output following trauma and severe hemorrhage even in the absence of blood resuscitation.
A number of beneficial effects of ATP-MgCl2 administration have been demonstrated in preheparinized models of shock and ischemia. However, it is not known whether ATP-MgCl2 restores and maintains the depressed cardiac output in a nonheparinized model of trauma and severe hemorrhage in which resuscitation following shock was provided only with crystalloid. To study this, rats underwent a midline laparotomy (i.e., trauma induced) and were then bled to and maintained at a mean arterial pressure of 40 mm Hg until 40% of the maximum shed blood volume was returned in the form of Ringer's lactate (RL). Animals were then resuscitated with 4 times the volume of shed blood with RL (4 X RL) during and following which ATP-MgCl2 (50 mumol/kg body weight each or an equivalent volume of normal saline) was infused intravenously. Cardiac output was determined every 15-30 min for 4.5 hr, using an in vivo hemoreflectometer and indocyanine green dilution technique. Resuscitation with 4 X RL transiently restored but did not maintain cardiac output; however, ATP-MgCl2 treatment restored and maintained cardiac output at control values. ATP-MgCl2 infusion also significantly decreased total peripheral resistance and attenuated tissue water content. Thus, ATP-MgCl2 appears to be a promising adjunct to the treatment of trauma-hemorrhage even in the absence of blood resuscitation.
Wang
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Department of Surgery, Michigan State University, East Lansing 48824-1315.
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Chaudry
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D000255:Adenosine Triphosphate / Q000494:pharmacology*; D000818:Animals; D002302:Cardiac Output / Q000187:drug effects*; D004195:Disease Models, Animal; D015636:Magnesium Chloride / Q000494:pharmacology*; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000188:drug therapy*; D014947:Wounds and Injuries / Q000188:drug therapy*
D015636:Magnesium Chloride; D000255:Adenosine Triphosphate