Comparative effects of crystalloid and small volume hypertonic hyperoncotic fluid resuscitation on hepatic microcirculation after hemorrhagic shock.
Hepatic microcirculation, leukocyte-endothelial interaction, and sinusoidal widths were studied by means of intravital microscopy in a non-heparinized fixed pressure hemorrhagic shock model in the rat. Asanguineous resuscitation was performed either with "adequate" amounts of lactated Ringer's solution (threefold shed volume/30 min) or 4 ml/kg/3 min 7.2% saline/10% Dextran 60 (HSDex) or 4 ml/kg/3 min 7.2% saline/10% hydroxyethylstarch 200/0.62 (HSHes). Hemorrhagic shock and resuscitation was paralleled by significant (P < 0.01) lumenal narrowing of sinusoids that remained largely uninfluenced by the type of fluid used for resuscitation (HSDex: 9.28 +/- 0.56; HSHes: 8.93 +/- 0.29, LR: 8.87 +/- 0.6 microns compared to 12.17 +/- 0.24 microns in controls). Whereas HSHes and LR-therapy resulted in comparably increased leukocyte adhesion to the sinusoidal wall, the dextran-containing solution led to a significant attenuation of leukocyte-endothelial interaction, suggesting involvement of dextran-binding adhesion molecules, e.g., selectins.
Bauer
M
M
Clinic for Anesthesiology and Critical Care Medicine, University of Saarland, Homburg, Germany.
Marzi
I
I
Ziegenfuss
T
T
Seeck
G
G
Bühren
V
V
Larsen
R
R
D000818:Animals; D002448:Cell Adhesion; D003911:Dextrans / Q000008:administration & dosage / Q000627:therapeutic use; D004730:Endothelium, Vascular / Q000166:cytology; D005260:Female; D005440:Fluid Therapy; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000627:therapeutic use; D006982:Hypertonic Solutions; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D007962:Leukocytes / Q000502:physiology; D008099:Liver / Q000098:blood supply*; D008833:Microcirculation / Q000503:physiopathology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000503:physiopathology / Q000628:therapy*
D003911:Dextrans; D006895:Hydroxyethyl Starch Derivatives; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D000077325:Ringer's Lactate