Fluid resuscitation with hemoglobin-vesicle solution does not increase hypoxia or inflammatory responses in moderate hemorrhagic shock.
The aim of the present study was to compare the hypoxic and inflammatory effects of transfusing hemoglobin-vesicles (HbV) or lactated Ringer's (LR) solution on several organs in a hemorrhagic shock model. Hemorrhagic shock was induced in 48 anesthetized rats by withdrawing 28 mL/kg blood. The animals were resuscitated by replacing the blood with an equal volume of HbV solution or three times the volume of LR solution. The heart, lung, liver, kidney and spleen were extracted at different time points following resuscitation, and mRNA expression levels of hypoxia-induced factor 1-alpha (HIF-1alpha) and tumor necrosis factor-alpha (TNF-alpha) were determined. Blood lactate concentrations in the HbV group rapidly returned to baseline levels, whereas elevated lactate concentrations in the LR group were prolonged. There were no significant differences between the two resuscitation groups in terms of HIF-1alpha and TNF-alpha expression in the organs examined. HIF-1alpha and TNF-alpha expression in the lungs was significantly greater than in other organs. Our results suggest that resuscitation from hemorrhagic shock with HbV did not increase hypoxic or inflammatory effects in major organs, compared with resuscitation using LR solution, despite prolonged elevation of blood lactate.
Goto
Yoshitugu
Y
Department of Anesthesiology, Nippon Medical School, Sendagi, Tokyo, Japan.
Terajima
Katsuyuki
K
Tsueshita
Takaya
T
Miyashita
Masao
M
Horinouchi
Hirohisa
H
Sakai
Hiromi
H
Tsuchida
Eishun
E
Sakamoto
Atsuhiro
A
D000818:Animals; D001794:Blood Pressure; D001802:Blood Substitutes / Q000009:adverse effects*; D006454:Hemoglobins / Q000009:adverse effects*; D000860:Hypoxia / Q000139:chemically induced*; D007249:Inflammation / Q000139:chemically induced*; D007552:Isotonic Solutions / Q000009:adverse effects*; D019344:Lactic Acid / Q000097:blood; D008297:Male; D009928:Organ Specificity; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D001802:Blood Substitutes; D006454:Hemoglobins; D007552:Isotonic Solutions; D012333:RNA, Messenger; D000077325:Ringer's Lactate; D014409:Tumor Necrosis Factor-alpha; D019344:Lactic Acid