title: Reduced rate of bacterial translocation and improved variables of natural killer cell and T-cell activity in rats surviving controlled hemorrhagic shock and treated with hypertonic saline.
abstract: OBJECTIVE
  To examine the effect of hypertonic saline on bacterial translocation and the number and function of natural killer and T cells in controlled hemorrhagic shock.
  
  
  METHODS
  Randomized controlled study. Duration of follow-up was 24 hrs.
  
  
  METHODS
  University research laboratory.
  
  
  METHODS
  Adult male Sprague-Dawley rats, weighing 310-390 g.
  
  
  METHODS
  Controlled hemorrhagic shock was induced by blood withdrawal (mean arterial pressure, 30-40 mm Hg) and maintained for 30 mins. The animals were randomly divided into three groups: group 1 (n = 10) was sham-operated, group 2 (n = 10) was untreated, and group 3 was treated with 5 mL/kg hypertonic saline (n = 10). The rats were killed after 24 hrs.
  
  
  RESULTS
  Infusion of hypertonic saline in group 3 was followed by reduced bacterial translocation rate (5.0 +/- 2.2% vs. 18.3 +/- 5.3%, p <.033). The total mass of bacteria isolated from hypertonic saline-treated animals with bacterial translocation was 7.8- to 10.4-fold less than that from untreated rats. Controlled hemorrhagic shock resulted in a low percentage of CD4+ cells in blood (35.2 +/- 3.9%, p <.05) and lymph nodes (44.4 +/- 4.5%, p <.05) and depressed CD4 expression on blood (82 +/- 13 arbitrary units, p <.005) and lymph node (168 +/- 24 arbitrary units, p <.03) cells. A compensatory mobilization of NKR-P1+ cells from lymph nodes (8.6 +/- 2.3%, p <.05) to blood (21.2 +/- 5.2%, p <.01) with down-regulated NKR-P1 expression on blood cells (59 +/- 10 arbitrary units, p <.005) was observed. Natural killer cell-mediated cytotoxicity was decreased (67.9 +/- 9.7%, p <.05). Hypertonic saline treatment greatly stimulated CD4 expression on blood (419 +/- 113 arbitrary units, p <.005) and lymph node (553 +/- 115 arbitrary units, p <.03) cells. Also, normalization of NKR-P1 expression (160 +/- 19 arbitrary units, p <.005) and restoration of natural killer cell-mediated cytotoxicity to near normal values (88.6 +/- 7.4%, p <.05) were demonstrated.
  
  
  CONCLUSIONS
  Controlled hemorrhagic shock was accompanied by CD4+ cells suppression and excessive recruitment of natural killer cells with abnormally low NKR-P1 expression and suppressed cytolytic activity into circulation. Infusion of hypertonic saline reversed these changes and reduced bacterial translocation.
authors.affiliation: Laboratory for Shock and Trauma Research and the Department of General Surgery, the B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Mark
authors.initials: M
authors.lastname: Hirsh
authors.forename: Larissa
authors.initials: L
authors.lastname: Dyugovskaya
authors.forename: Yulia
authors.initials: Y
authors.lastname: Bashenko
authors.forename: Michael M
authors.initials: MM
authors.lastname: Krausz
mesh_terms: D000818:Animals; D018988:Bacterial Translocation / Q000502:physiology*; D018791:CD4 Lymphocyte Count; D007694:Killer Cells, Natural / Q000276:immunology*; D008198:Lymph Nodes; D008297:Male; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000276:immunology* / Q000382:microbiology; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D012462:Saline Solution, Hypertonic