title: Resuscitation with lactated Ringer's solution in rats with hemorrhagic shock induces immediate apoptosis.
abstract: BACKGROUND
  We hypothesize that different resuscitative fluids may immediately affect the degree of apoptosis after hemorrhagic shock.
  
  
  METHODS
  Rats (n = 35) were hemorrhaged 27 mL/kg over 5 minutes followed by 1 hour of shock, then resuscitation over 1 hour. The six treatment groups were sham hemorrhage, sham resuscitation, whole blood resuscitation, lactated Ringer's solution (LR) resuscitation with three times the volume bled, sham hemorrhage with LR infusion, and 7.5% hypertonic saline resuscitation (9.7 mL/kg). Liver and small intestine were harvested immediately after resuscitation. Apoptosis was evaluated by using in situ cell death detection method.
  
  
  RESULTS
  Resuscitation with LR resulted in a significant increase in small intestinal and liver apoptosis. Animals that received LR infusion without hemorrhage had an increased level of apoptosis in the intestine. Apoptosis in the intestine was observed in both the mucosa and muscularis externa. There was no increase in apoptosis in either organ in the animals resuscitated with sham resuscitation, whole blood, and hypertonic saline compared with the sham hemorrhage group.
  
  
  CONCLUSIONS
  Resuscitation with LR solution after hemorrhagic shock increased immediate cell death by apoptosis in both the small intestine and liver. There was no significant increase in apoptosis in the animals resuscitated with hypertonic saline, whole blood, or in unresuscitated animals. Thus, the type of resuscitation fluid used may affect the apoptotic cellular response to shock.
authors.affiliation: Department of Surgery, National Naval Medical Center, Bethesda, Maryland, USA.
authors.forename: S
authors.initials: S
authors.lastname: Deb
authors.forename: B
authors.initials: B
authors.lastname: Martin
authors.forename: L
authors.initials: L
authors.lastname: Sun
authors.forename: P
authors.initials: P
authors.lastname: Ruff
authors.forename: D
authors.initials: D
authors.lastname: Burris
authors.forename: N
authors.initials: N
authors.lastname: Rich
authors.forename: S
authors.initials: S
authors.lastname: DeBreux
authors.forename: B
authors.initials: B
authors.lastname: Austin
authors.forename: P
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000818:Animals; D017209:Apoptosis; D001794:Blood Pressure / Q000187:drug effects; D001803:Blood Transfusion; D016923:Cell Death; D007421:Intestine, Small / Q000473:pathology; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008099:Liver / Q000473:pathology; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation / Q000379:methods*; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000503:physiopathology / Q000628:therapy*
chemical_list: D007552:Isotonic Solutions; D000077325:Ringer's Lactate