title: Effect of different resuscitation fluids on cytokine response in a rat model of hemorrhagic shock.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, and National Taiwan University, College of Medicine, Taipei, Taiwan.
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Lee
authors.forename: I-Jing
authors.initials: IJ
authors.lastname: Chang
authors.forename: Zui-Shen
authors.initials: ZS
authors.lastname: Yen
authors.forename: Chiung-Yuan
authors.initials: CY
authors.lastname: Hsu
authors.forename: Shey-Yiny
authors.initials: SY
authors.lastname: Chen
authors.forename: Chan-Ping
authors.initials: CP
authors.lastname: Su
authors.forename: Wen-Chu
authors.initials: WC
authors.lastname: Chiang
authors.forename: Shyr-Chyr
authors.initials: SC
authors.lastname: Chen
authors.forename: Wen-Jone
authors.initials: WJ
authors.lastname: Chen
mesh_terms: 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
chemical_list: D016207:Cytokines; D006895:Hydroxyethyl Starch Derivatives; D015850:Interleukin-6; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10