Release of protein S100B in haemorrhagic shock: effects of small volume resuscitation combined with arginine vasopressin.
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.
Meybohm
Patrick
P
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel, Germany. meybohm@anaesthesie.uni-kiel.de
Cavus
Erol
E
Dörges
Volker
V
Weber
Bernd
B
Stadlbauer
Karl-Heinz
KH
Wenzel
Volker
V
Scholz
Jens
J
Steffen
Martin
M
Bein
Berthold
B
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
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