title: Release of protein S100B in haemorrhagic shock: effects of small volume resuscitation combined with arginine vasopressin.
abstract: BACKGROUND
  The present study was designed to evaluate the effect of conventional fluid resuscitation and small volume resuscitation alone and combined with arginine vasopressin (AVP) on cerebral perfusion pressure (CPP) and protein S100B during experimental haemorrhagic shock.
  
  
  METHODS
  Thirty anaesthetised pigs underwent a penetrating liver trauma. Following haemodynamic decompensation, pigs received either (1) a combination of crystalloid (40 mL kg(-1)) and colloid (20 mL kg(-1)) solutions (fluid, n=10), (2) hypertonic-hyperoncotic solution (HHS; 4 mL kg(-1)) combined with normal saline (HHS+NS; n=10) or (3) HHS combined with AVP (0.2 U kg(-1) followed by an infusion of 2 U kg(-1)h(-1); HHS+AVP; n=10).
  
  
  RESULTS
  Compared to baseline, CPP decreased and S100B levels increased significantly at haemodynamic decompensation (S100B: fluid, 0.52+/-0.23 microg L(-1) vs. 0.85+/-0.37 microg L(-1), p<0.05; HHS+NS, 0.47+/-0.18 microg L(-1) vs. 0.90+/-0.33 microg L(-1), p<0.05; HHS+AVP, 0.53+/-0.18 microg L(-1) vs. 0.90+/-0.39 microg L(-1), p<0.01). During the initial 10 min of therapy, CPP of HHS+NS was significantly higher compared to the fluid group, increased more rapidly in the HHS+AVP group, but was not significantly different thereafter. S100B levels decreased close to baseline values (p<0.001), and did not differ between groups.
  
  
  CONCLUSIONS
  HHS+AVP resulted in higher CPP compared to fluid and HHS+NS in the initial phase of therapy, but did not differ thereafter. Haemorrhage-induced hypotension yielded increased S100B levels that were comparable in groups throughout the study period.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel, Germany. meybohm@anaesthesie.uni-kiel.de
authors.forename: Patrick
authors.initials: P
authors.lastname: Meybohm
authors.forename: Erol
authors.initials: E
authors.lastname: Cavus
authors.forename: Volker
authors.initials: V
authors.lastname: Dörges
authors.forename: Bernd
authors.initials: B
authors.lastname: Weber
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Stadlbauer
authors.forename: Volker
authors.initials: V
authors.lastname: Wenzel
authors.forename: Jens
authors.initials: J
authors.lastname: Scholz
authors.forename: Martin
authors.initials: M
authors.lastname: Steffen
authors.forename: Berthold
authors.initials: B
authors.lastname: Bein
mesh_terms: D000818:Animals; D001127:Arginine Vasopressin / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003102:Colloids; D000077324:Crystalloid Solutions; D004195:Disease Models, Animal; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D007427:Intracranial Pressure / Q000187:drug effects; D007552:Isotonic Solutions; D008099:Liver / Q000293:injuries; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D011446:Prospective Studies; D015532:Rehydration Solutions / Q000008:administration & dosage; D012151:Resuscitation / Q000379:methods*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D012462:Saline Solution, Hypertonic; D012771:Shock, Hemorrhagic / Q000097:blood* / Q000188:drug therapy; D013552:Swine
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D006490:Hemostatics; D007552:Isotonic Solutions; D009414:Nerve Growth Factors; D015532:Rehydration Solutions; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D012462:Saline Solution, Hypertonic; D001127:Arginine Vasopressin