Administration of ATP-MgCl2 after trauma-hemorrhage and resuscitation restores the depressed cardiac performance.
Although adenosine triphosphate (ATP)-MgCl2 has been shown to improve cardiac performance under normal and postischemic conditions, it is not known whether this agent has any salutary effects on cardiac performance following trauma-hemorrhage and crystalloid resuscitation. To determine this, rats underwent laparotomy (i.e., trauma induction) and were 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. The animals were then resuscitated with four times the volume of shed blood using Ringer's lactate over 60 min and received either ATP-MgCl2 (50 mumole/kg body wt) in 1 ml volume or an equivalent volume of normal saline intravenously over 95 min. Maximum dP/dt during contraction as well as relaxation (+/-dP/dtmax) and ventricular peak systolic pressure (VPSP) were determined 15 min prior to the end of resuscitation and every 30 min thereafter for 4 hr after the completion of resuscitation. The results indicate that both -dP/dtmax and +dP/dtmax decreased significantly beginning at 0 and 2 hr after the completion of resuscitation, respectively, and remained depressed throughout the duration of the study in saline-treated animals. In addition, VPSP was significantly depressed at 2-4 hr after resuscitation. Treatment with ATP-MgCl2, however, restored these parameters. Moreover, the depressed heart rate was also restored following ATP-MgCl2 administration. Since ATP-MgCl2 restores various left ventricular performance parameters, this agent appears to be a promising adjunct for improving cardiac function after trauma and hemorrhage, even in the absence of blood resuscitation.
Robinson
D A
DA
Department of Surgery, Michigan State University, East Lansing 48824, USA.
Wang
P
P
Chaudry
I H
IH
D000255:Adenosine Triphosphate / Q000627:therapeutic use*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D003971:Diastole; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006470:Hemorrhage / Q000628:therapy*; D007813:Laparotomy; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects; D011312:Pressure; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left / Q000187:drug effects; D014947:Wounds and Injuries / Q000628:therapy*
D000255:Adenosine Triphosphate