Mild or moderate hypothermia but not increased oxygen breathing prolongs survival during lethal uncontrolled hemorrhagic shock in rats, with monitoring of visceral dysoxia.
OBJECTIVE
To test the hypotheses that during lethal uncontrolled hemorrhagic shock (UHS) in rats compared with normothermia and room air breathing: a) mild hypothermia would prolong survival time as well as moderate hypothermia; b) oxygen breathing would prolong survival further; and c) hypothermia and oxygen would mitigate visceral ischemia (dysoxia) during UHS.


METHODS
Prospective, randomized, controlled laboratory animal study.


METHODS
Animal research facility.


METHODS
Male Sprague-Dawley rats.


METHODS
Fifty-four rats were lightly anesthetized with halothane during spontaneous breathing. UHS was induced by blood withdrawal of 3 mL/100 g over 15 mins, followed by 75% tail amputation with topical application of heparin. Five minutes after tail cut, rats were randomly divided into nine groups (6 rats each) with three rectal temperature levels (38 degrees C [100.4 degrees F; normothermia] vs. 34 degrees C [93.2 degrees F; mild hypothermia] vs. 30 degrees C [86 degrees F; moderate hypothermia]) by surface cooling; each with 3 FIO2 levels (0.25 vs. 0.5 vs. 1.0). Rats were observed without fluid resuscitation until death (apnea and pulselessness). Visceral ischemia was monitored by observing liver and gut surface PCO2.


RESULTS
Mean survival time, which was 51 mins in the control group with normothermia and FIO2 of 0.25, was more than doubled with hypothermia, to 119 mins in the combined mild hypothermia groups (p < .05) and to 132 mins in the combined moderate hypothermia groups (p < .05; NS for moderate vs. mild hypothermia). FIO2 had no statistically significant effect on survival time. Increases in visceral surface PCO2 correlated with hypotension (r2 = .22 for intestine and .40 for liver). Transiently, increased FIO2, not hypothermia, mitigated visceral ischemia.


CONCLUSIONS
Both mild and moderate hypothermia prolonged survival time during untreated, lethal UHS in rats. Increased FIO2 had no effect on survival. The effects of hypothermia and increased FIO2 during UHS on viscera, the ability to be resuscitated, and outcome should be explored further.
Takasu
A
A
Safar Center for Resuscitation Research, Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh School of Medicine, PA 15260, USA.
Carrillo
P
P
Stezoski
S W
SW
Safar
P
P
Tisherman
S A
SA
D000818:Animals; D001784:Blood Gas Analysis; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D006400:Hematocrit; D006439:Hemodynamics; D007036:Hypothermia, Induced / Q000379:methods*; D000860:Hypoxia / Q000209:etiology*; D007511:Ischemia / Q000209:etiology*; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011446:Prospective Studies; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012771:Shock, Hemorrhagic / Q000150:complications / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016019:Survival Analysis; D013997:Time Factors; D014781:Viscera / Q000098:blood supply*