Effects of different resuscitation fluids on the rheologic behavior of red blood cells, blood viscosity and plasma viscosity in experimental hemorrhagic shock.
BACKGROUND
Hemorrhagic shock is associated with severe rheological abnormalities. We hypothesized that in the setting of hemorrhagic shock, resuscitation can alter hemorheological characteristics dramatically, and different fluids cause different effects. The aim of this study was to investigate whether the type of fluid administered has an impact on hemorheological characteristics at the early stage of resuscitation in a rodent model of hemorrhagic shock.


METHODS
Animals were randomized into five groups: (1) sham hemorrhage (SHAM); (2) shock and sham resuscitation (SHOCK); (3) shock and resuscitation with normal saline 32 ml/kg (NS); (4) shock and resuscitation with 7.5% hypertonic saline 4 ml/kg (HS); (5) shock and resuscitation with 7.5% hypertonic saline/6% Dextran 70 4 ml/kg (HSD). Hemorheological characteristics were measured at 60 min after resuscitation.


RESULTS
Results showed that NS resuscitation deteriorated red blood cell (RBC) deformability compared with the SHOCK group. The HS group showed improved RBC deformability compared with the NS group, although the differences were not statistically significant. There were significant improvements of RBC deformability at all shear rates in the HSD group compared with the NS group. Whole blood and plasma viscosities decreased significantly in the SHOCK group compared with the SHAM group. At shear rates of 60 and 150 s(-1), the NS group decreased whole blood viscosity compared with the SHOCK group. The HSD group showed elevated plasma viscosity compared with the SHOCK, NS and HS groups.


CONCLUSIONS
These results suggested that at the early stage of hemorrhagic shock resuscitation, hypertonic-hyperoncotic resuscitation could improve RBC deformability compared with isotonic crystalloid resuscitation. Dextran 70 could elevate plasma viscosity to nearly baseline level. These effects of hypertonic-hyperoncotic resuscitation could be beneficial to maintain microcirculation.
Zhao
Lian
L
Department of Immunohematology, Beijing Institute of Transfusion Medicine, Beijing 100850, China.
Wang
Bo
B
You
Guoxing
G
Wang
Ziling
Z
Zhou
Hong
H
D000818:Animals; D001783:Blood Flow Velocity / Q000187:drug effects*; D003911:Dextrans / Q000008:administration & dosage; D004195:Disease Models, Animal; D004907:Erythrocyte Deformability / Q000187:drug effects*; D010952:Plasma Substitutes / Q000008:administration & dosage; D011897:Random Allocation; D051381:Rats; D012151:Resuscitation / Q000379:methods*; D012212:Rheology; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D012771:Shock, Hemorrhagic / Q000503:physiopathology / Q000628:therapy*; D012965:Sodium Chloride / Q000008:administration & dosage
D003911:Dextrans; D010952:Plasma Substitutes; D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride