Anti-inflammatory treatment with standardized human serum protein solution reduces local and systemic inflammatory response after hemorrhagic shock.
OBJECTIVE
Reperfusion after hemorrhagic shock leads to local and systemic inflammatory response. This study evaluates the effect of a short-term treatment with standardized human serum protein solution (SPS) on the local and systemic inflammatory response in the mesenteric microcirculation in the rat.


METHODS
Spontaneously breathing animals underwent median laparotomy and exteriorization of an ileal loop for intravital microscopy of the mesenteric microcirculation. Volume-controlled hemorrhagic shock was set by arterial blood withdrawal (2.5 ml/100 g body weight for 60 min), followed by reperfusion for 4 h. SPS (n = 10) or saline 0.9% (controls, n = 10) was given intravenously as a continuous infusion for 30 min at the beginning of reperfusion ('pre-hospital'). This was followed in both groups by substitution of blood and normal saline to support blood pressure ('in-hospital'). Systemic hemodynamics, mesenteric microcirculation and arterial blood gases were monitored before, during and after shock, and for 4 h after initiation of reperfusion.


RESULTS
SPS treatment markedly reduced leukocyte/endothelial interaction, and reduced the need for intravenous fluids compared to controls. For the entire observation period, blood pH was unchanged from baseline only in SPS-treated animals. The improvement of base excess and abdominal blood flow persisted for 2 h after SPS infusion.


CONCLUSIONS
Short-term SPS treatment of hemorrhagic shock improved mesenteric microcirculation, arterial blood gases and global hemodynamics, and attenuated the inflammatory response to reperfusion. It may provide clinical benefit when applied at an early phase of reperfusion after hemorrhagic shock.
Lauterbach
Michael
M
Institute for Neurosurgical Pathophysiology, Johannes Gutenberg University Mainz, Mainz, Germany. mlauterbach@rics.bwh.harvard.edu
Horstick
Georg
G
Kempf
Tibor
T
Weilemann
L S
LS
Munzel
Thomas
T
Kempski
Oliver
O
D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects; D001798:Blood Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D002496:Central Venous Pressure / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley; D012771:Shock, Hemorrhagic / Q000188:drug therapy*
D000893:Anti-Inflammatory Agents; D001798:Blood Proteins