title: The effect of hypoxemic resuscitation of hemorrhagic shock on hemodynamic stabilization and inflammatory response: a pilot study in a rat experimental model.
abstract: BACKGROUND
  Resuscitation of hemorrhagic shock is associated with tissue injury. The effect of hypoxemia during resuscitation was investigated.
  
  
  METHODS
  Shock was induced by withdrawing blood to mean arterial pressure (MAP) 40 mm Hg and maintained for 60 minutes in 25 Wistar rats. Animals were randomly divided to receive either normoxemic (controls, FiO2 = 21%, n = 14) or hypoxemic (HypRes, FiO2 = 12%, n = 11) resuscitation by re-infusing their shed blood. Outcome was assessed through hemodynamic and inflammatory parameters. Another nine rats served to correlate different FiO2 to the corresponding PaO2.
  
  
  RESULTS
  At 60 minutes of resuscitation HypRes had higher MAP than control animals (p = 0.008). The respective median (range) malondialdehyde and TNF-alpha levels was 1.7 (1-2.1) versus 3.1 (2.4-4.3) micromol/L, (p = 0.02) and 0 versus 5.8 (0-5.8) pg/mL, (p = 0.025). Glutathione, endotoxin, interferon-gamma, and nitric oxide values were similar between groups. FiO2 of 12% induced only a mild hypoxemia (PaO2 approximately 80 mm Hg).
  
  
  CONCLUSIONS
  Even mild hypoxemia during resuscitation of shock leads to effective hemodynamic stabilization.
authors.affiliation: Department of Critical Care, University of Athens Medical School, Athens, Greece. edouzin@cc.uoa.gr
authors.forename: Emmanuel E
authors.initials: EE
authors.lastname: Douzinas
authors.forename: Olga
authors.initials: O
authors.lastname: Livaditi
authors.forename: Anastasios G
authors.initials: AG
authors.lastname: Xiarchos
authors.forename: Evangelos J
authors.initials: EJ
authors.lastname: Giamarellos-Bourboulis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Villiotou
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Liappas
authors.forename: Evangelos
authors.initials: E
authors.lastname: Evangelou
authors.forename: Alexandros D
authors.initials: AD
authors.lastname: Rapidis
authors.forename: Charis
authors.initials: C
authors.lastname: Roussos
mesh_terms: D000818:Animals; D001794:Blood Pressure; D001803:Blood Transfusion; D005978:Glutathione / Q000097:blood; D000860:Hypoxia; D018836:Inflammation Mediators / Q000097:blood; D007371:Interferon-gamma / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D051381:Rats; D017208:Rats, Wistar; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000097:blood / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; D008315:Malondialdehyde; D007371:Interferon-gamma; D005978:Glutathione