title: Hypertonic saline and pentoxifylline prevent lung injury and bacterial translocation after hemorrhagic shock.
abstract: Previous reports have shown beneficial effects of pentoxifylline (PTX) and hypertonic saline (HS) in the treatment of hemorrhagic shock. We compared the effects of these solutions to those of conventional lactated Ringer's (LR) treatment on bacterial translocation (BT), lung injury and total and differential cell count in the bronchoalveolar lavage fluid (BAL) after hemorrhagic shock. Rats (280-330 g) were bled to a MAP of 35 mmHg for 1 h and then randomized into 4 groups: LR (3x shed blood); HS (7,5% NaCl, 4 mL/kg); LR+PTX (25 mg/kg) and SHAM (no shock, no treatment). Additionally, total shed blood was reinfused. At 24 h lung injury was analyzed by a pathologist blinded to the groups, and a score was calculated. BT was determined by microbiological cultures of mesenteric lymph node complex. BAL was performed on a separate set of animals that received the same treatments. Lung score was significantly higher in LR group (11.5+/-1.4) as compared to HS (6.8+/-0.9), and PTX treated animals (7.2+/-0.9). The percentage of neutrophils in the BAL of LR animals (15.8%) was also significantly higher as compared with HS (5.25%) and PTX groups (9.72%). BT was noted in 50% of rats for LR group, 30% for PTX, 10% for HS and 0% for sham group. HS and PTX reduced BT and lung injury after hemorrhage. Attenuation of lung injury could be the result of less neutrophil infiltration into the lungs of HS and PTX treated animals. LR resuscitation caused pronounced lung injury and BT.
authors.affiliation: Research Division, Heart Institute (InCor), University of Sao Paulo Medical School, SP, Brazil.
authors.forename: M M
authors.initials: MM
authors.lastname: Yada-Langui
authors.forename: R
authors.initials: R
authors.lastname: Coimbra
authors.forename: C
authors.initials: C
authors.lastname: Lancellotti
authors.forename: I
authors.initials: I
authors.lastname: Mimica
authors.forename: C
authors.initials: C
authors.lastname: Garcia
authors.forename: N
authors.initials: N
authors.lastname: Correia
authors.forename: M
authors.initials: M
authors.lastname: Rocha e Silva
mesh_terms: D000818:Animals; D001419:Bacteria / Q000302:isolation & purification; D008168:Lung / Q000187:drug effects / Q000382:microbiology*; D055370:Lung Injury; D008297:Male; D010431:Pentoxifylline / Q000627:therapeutic use*; D051381:Rats; D017208:Rats, Wistar; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D012771:Shock, Hemorrhagic / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D012462:Saline Solution, Hypertonic; D014665:Vasodilator Agents; D010431:Pentoxifylline