Effects of different resuscitation fluids on tissue blood flow and oxidant injury in experimental rhabdomyolysis.
OBJECTIVE
This study was performed to evaluate the effects of 0.9% saline (SAL), 0.9% saline + sodium bicarbonate + mannitol (SAL/BIC/MAN), and hypertonic saline-dextran (HSD) on hemodynamic variables, tissue blood flow, and oxidant injuries in experimental traumatic rhabdomyolysis (TR) in rats subjected allogeneic muscle extract infusion.


METHODS
Prospective, randomized, experimental.


METHODS
Physiology experiment laboratory.


METHODS
Male Sprague-Dawley rats, weighing 250-300 g.


METHODS
All groups (n = 8 each) underwent femoral artery and vein catheterization. The animals in the TR, SAL, SAL/BIC/MAN, and HSD groups received an infusion of 2 mL of autologous muscle extract for 60 mins. After autologous muscle extract infusion, the SAL and HSD groups received 30 mL/kg 0.9% saline for 30 mins or 4 mL/kg HSD for 5 mins, respectively. The SAL/BIC/MAN group received 30 mL/kg 0.9% saline for 30 mins plus a bolus of 1 g/kg mannitol and a bolus of 2 mEq/kg sodium bicarbonate diluted in 1 mL of saline. At 2 hrs of autologous muscle extract infusion, erythrocyte flows in liver and kidney were measured by using a laser Doppler flowmeter. Then, blood samples and kidney and liver biopsies were taken to measure levels of glutathione and malondialdehyde.


RESULTS
TR caused decreases in mean arterial pressure, tissue blood flow, and tissue glutathione and an increase in malondialdehyde. Rats in the HSD group had significant metabolic acidosis. SAL resuscitation did not correct tissue blood flow and prevent oxidant injury. HSD increased tissue blood flow, mean arterial pressure, and liver and kidney glutathione and decreased serum, liver, and kidney malondialdehyde. SAL/BIC/MAN resuscitation corrected all oxidant damage variables but did not increase tissue blood flow. SAL/BIC/MAN preserved serum malondialdehyde and liver glutathione better than the HSD did.


CONCLUSIONS
HSD prevented oxidant injury and restored tissue blood flow but increased metabolic acidosis that followed autologous muscle extract infusion. SAL/BIC/MAN seems to be more effective than HSD in decreasing oxidant injury. Further research on the effects of the solute overload and metabolic acidosis due to HSD resuscitation on renal function in experimental rhabdomyolysis is warranted.
Ozgüç
Halil
H
Department of Surgery, Uludag University Medical School, Bursa, Turkey.
Kahveci
Nevzat
N
Akköse
Sule
S
Serdar
Zehra
Z
Balci
Veysel
V
Ocak
Ozgür
O
D000136:Acid-Base Equilibrium / Q000187:drug effects; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D003911:Dextrans / Q000627:therapeutic use*; D004338:Drug Combinations; D007668:Kidney / Q000098:blood supply; D008099:Liver / Q000098:blood supply; D008297:Male; D008315:Malondialdehyde / Q000097:blood / Q000378:metabolism*; D008353:Mannitol / Q000008:administration & dosage / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015532:Rehydration Solutions / Q000627:therapeutic use*; D012151:Resuscitation / Q000379:methods*; D012206:Rhabdomyolysis / Q000628:therapy*; D017693:Sodium Bicarbonate / Q000008:administration & dosage / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use*
D003911:Dextrans; D004338:Drug Combinations; D015532:Rehydration Solutions; C104375:hypertonic saline-dextran solution; D008353:Mannitol; D012965:Sodium Chloride; D008315:Malondialdehyde; D017693:Sodium Bicarbonate