Does the type of resuscitative fluid affect healing of colonic anastomosis in experimentally induced hemorrhagic shock in rats?
OBJECTIVE
The aim of the study was to investigate the effects of different resuscitative fluids on the healing of intestinal anastomosis in a hemorrhagic-shock rat model.


METHODS
Closed-colony Wistar male rats (n = 40; 8 rats per group) were subjected to volume-controlled hemorrhagic shock, followed by a 30-min shock phase. The animals were then resuscitated with one of the following fluids (which also corresponds to their respective groups): lactated Ringer's solution (LR), hydroxyethyl starch (HES), 7.5% hypertonic saline (HS) and autologous blood (AB). There was also a control group (CL), which did not experience hemorrhagic shock or receive any resuscitative fluids. All rats underwent laparotomy, segmental resection and anastomosis of the left colon. Five days later, a 2nd laparotomy was performed and the anastomotic bursting pressure was measured in vivo. Thereafter, the anastomosed segment was resected to measure the tissue hydroxyproline level and the grade of anastomotic fibrosis.


RESULTS
All experimental groups (LR, HES, HS and AB) exhibited lower anastomotic bursting pressures than the CL group; however, no intergroup differences achieved statistical significance. The mean tissue hydroxyproline level and fibrosis grade also were similar across all 5 groups.


CONCLUSIONS
In traumatic hemorrhagic shock, anastomosis safety does not appear to be affected by the type of fluid used for resuscitation. Moreover, LR, HES and HS all seemed to reinforce healing as effectively as transfused blood.
Harlak
Ali
A
Department of Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
Can
Mehmet Fatih
MF
Mentes
Oner
O
Ersoz
Nail
N
Kurt
Bulent
B
Turker
Turker
T
Yagci
Gokhan
G
Tufan
Turgut
T
D000714:Anastomosis, Surgical; D000818:Animals; D001804:Blood Transfusion, Autologous; D003106:Colon / Q000473:pathology / Q000601:surgery*; D005355:Fibrosis / Q000503:physiopathology; D005440:Fluid Therapy / Q000379:methods; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D006909:Hydroxyproline / Q000097:blood; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D010952:Plasma Substitutes / Q000627:therapeutic use*; D051381:Rats; D017208:Rats, Wistar; D012151:Resuscitation / Q000379:methods*; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000401:mortality / Q000628:therapy*; D014945:Wound Healing
D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate; D006909:Hydroxyproline