Pyruvate-fortified fluid resuscitation improves hemodynamic stability while suppressing systemic inflammation and myocardial oxidative stress after hemorrhagic shock.
OBJECTIVE
To determine whether controlled resuscitation with pyruvate-fortified Ringer's (PR) solution vs. conventional lactate Ringer's (LR) more effectively stabilizes mean arterial pressure (MAP) and suppresses myocardial inflammation postresuscitation.


METHODS
Goats were hemorrhaged (255 +/- 22 ml) to lower MAP to 48 +/- 1 mmHg. Next, the right femoral vessels were occluded for 90 min to model tourniquet application. Beginning at 30 min occlusion, LR or PR was infused i.v. at 10 ml/min for 90 min. The femoral occlusions were released at 60 min infusion.


RESULTS
At 4 h postocclusion, MAP (mmHg) was increased in PR (59 +/- 4) vs. LR (47 +/- 3) resuscitated goats (p < 0.05). PR also more effectively augmented circulating HCO3 and total base excess. Nitrosative stress, detected in myocardium 4 h after LR resuscitation, was suppressed by PR. Finally, PR prevented the increase in circulating neutrophils that accompanied LR resuscitation.


CONCLUSIONS
Relative to LR, resuscitation with PR more effectively stabilized MAP, suppressed myocardial nitrosative stress and minimized systemic inflammation after hemorrhagic shock with hindlimb ischemia-reperfusion.
Flaherty
Devin C
DC
Department of Integrative Physiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA.
Hoxha
Besim
B
Sun
Jie
J
Gurji
Hunaid
H
Simecka
Jerry W
JW
Mallet
Robert T
RT
Olivencia-Yurvati
Albert H
AH
D000818:Animals; D004195:Disease Models, Animal; D004338:Drug Combinations; D005440:Fluid Therapy / Q000379:methods*; D006041:Goats; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D007249:Inflammation / Q000209:etiology / Q000628:therapy*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics; D007773:Lactates / Q000378:metabolism; D007958:Leukocyte Count; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D009504:Neutrophils; D018384:Oxidative Stress; D019289:Pyruvic Acid / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012151:Resuscitation / Q000379:methods; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D016896:Treatment Outcome; D014443:Tyrosine / Q000031:analogs & derivatives / Q000378:metabolism
D004338:Drug Combinations; D007552:Isotonic Solutions; D007773:Lactates; D000077325:Ringer's Lactate; C002744:3-nitrotyrosine; D014443:Tyrosine; D019289:Pyruvic Acid