Effect of different resuscitation fluids on cytokine response in a rat model of hemorrhagic shock.
This study was designed to determine the effects of different resuscitation fluids on the production of proinflammatory and anti-inflammatory cytokines in an animal model of hemorrhagic shock. Wistar male rats (n = 24; 8/group) were subjected to a volume-controlled hemorrhagic shock for 30 minutes and resuscitated as follows: (1) sham group without resuscitation, (2) lactated Ringer solution (LR), 3:1; (3) 4% hydroxyethyl starch (HES) solution, 1:1; and (4) 4% modified fluid gelatin (GEL), 1:1. Hemodynamic parameters were recorded, and blood samples were collected at 0 min and 30, 90, 150, 210, 270, and 330 min after hemorrhage for plasma levels of IL-6, IL-10, and TNFalpha. The circulating concentrations of IL-6 at 90, 150, 210, 270, and 330 min and TNFalpha levels at 150, 210, and 270 min after hemorrhage were significantly elevated in animals resuscitated with GEL compared with HES or LR (P < 0.05). At 210, 270, and 330 min, IL-10 concentration was decreased significantly in GEL-resuscitated rats compared with rats resuscitated with LR or HES (P < 0.05). Mean blood pressure and serum levels of lactate after resuscitation were not different among three kinds of fluids. LR, HES, and GEL are comparable in volume efficacy for resuscitation of hemorrhagic shock but are associated with different postresuscitation immune responses. Resuscitation with GEL may be associated with cytokine production favoring a proinflammatory response. The marked elevation of IL-6 observed in the GEL-treated animals may play a role in the relatively high frequency of anaphylactoid reaction in clinical use of GEL.
Lee
Chien-Chang
CC
Department of Emergency Medicine, National Taiwan University Hospital, and National Taiwan University, College of Medicine, Taipei, Taiwan.
Chang
I-Jing
IJ
Yen
Zui-Shen
ZS
Hsu
Chiung-Yuan
CY
Chen
Shey-Yiny
SY
Su
Chan-Ping
CP
Chiang
Wen-Chu
WC
Chen
Shyr-Chyr
SC
Chen
Wen-Jone
WJ
D000818:Animals; D001794:Blood Pressure; D016207:Cytokines / Q000096:biosynthesis / Q000378:metabolism*; D004195:Disease Models, Animal; D005440:Fluid Therapy / Q000379:methods*; D006400:Hematocrit; D006470:Hemorrhage / Q000628:therapy; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology; D007249:Inflammation; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007552:Isotonic Solutions / Q000494:pharmacology; D008168:Lung / Q000378:metabolism; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D012151:Resuscitation / Q000379:methods*; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000628:therapy*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D006895:Hydroxyethyl Starch Derivatives; D015850:Interleukin-6; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10