title: Impact of thyroid hormone administration on fluid requirements and hepatic injury markers in hemorrhagic shock due to liver trauma.
abstract: BACKGROUND
  The aim of the present study was to evaluate the effect of triiodothyronine (T3) administration in a porcine model of hemorrhagic shock due to liver surgery, in terms of hemodynamic stability, acid-base status, and hepatic injury markers.
  
  
  METHODS
  Hemorrhagic shock was induced in swine by left lobe liver resection and allowed bleeding to a mean arterial pressure of 35-40 mmHg for 40 min. Animals were randomly assigned into a sham group (n = 5), a fluid-resuscitated group (n = 7), and a fluid plus T3-resuscitated group (n = 7). T3 was given by continuous intravenous infusion from the beginning of the experiment. After the 40 min of shock animals were resuscitated with the aim of restoring mean arterial pressure (±10% from baseline). Resuscitation lasted for 1 hr and then swine were followed for another 460 min (total 6 hr). Blood loss, hamodynamic parameters, fluids administered, acid-base status, and liver enzymes were measured.
  
  
  RESULTS
  Blood loss was similar in both groups. Animals treated with T3 required less fluids than swine resuscitated with crystalloids and colloids only (N/S 0.9%: 1071 ± 189 ml vs. 2429 ± 535 ml, Voluven 6%: 550 ± 96 ml vs. 1000 ± 289 ml, p < .05), plus they were less acidotic at the end of the observing period (7.38 ± 0.08 vs. 7.26 ± 0.12, p < .05). Tachycardia was not associated with T3 administration. Hepatic enzymes did not exhibit differences between groups.
  
  
  CONCLUSIONS
  Our study demonstrates the beneficial impact of T3 administration during controlled hemorrhagic shock and resuscitation. Animals resuscitated with T3 necessitate less amounts of fluids to maintain hemodynamic stability and acid-base status. Moreover, T3 administration does not seem to aggravate blood loss or harm the hepatic tissue.
authors: 1 2nd Department of Anesthesia, Attikon Hospital, University of Athens, Medical School, Chaidari, Greece.
authors: Iosifina
authors: I
authors: Karmaniolou
authors: Constantinos
authors: C
authors: Pantos
authors: Nikolaos
authors: N
authors: Orfanos
authors: Anastasios
authors: A
authors: Mylonas
authors: Kassiani
authors: K
authors: Theodoraki
authors: Chryssoula
authors: C
authors: Staikou
authors: Eirini
authors: E
authors: Stergiou
authors: Georgia
authors: G
authors: Kostopanagiotou
authors: Vassilios
authors: V
authors: Smyrniotis
authors: Nikolaos
authors: N
authors: Arkadopoulos
mesh_terms: D000136:Acid-Base Equilibrium; D000818:Animals; D000077324:Crystalloid Solutions; D005440:Fluid Therapy; D006439:Hemodynamics; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000627:therapeutic use; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000188:drug therapy*; D013552:Swine; D014284:Triiodothyronine / Q000627:therapeutic use*
chemical_list: D000077324:Crystalloid Solutions; C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D014284:Triiodothyronine