Pyruvate Ringer's solution corrects lactic acidosis and prolongs survival during hemorrhagic shock in rats.
BACKGROUND
Lactic acidosis is a life-threatening complication of hemorrhagic shock. There is no ideal therapy for it in the clinical setting.


OBJECTIVE
This study was designed to investigate whether pyruvate Ringer's solution could treat hypoxic lactic acidosis associated with lethal hemorrhagic shock in rats.


METHODS
A total of 54 rats were subjected to hemorrhagic shock with mean arterial pressure (MAP) of 40 mm Hg for 1 h. They were then randomly divided into three groups (n = 18 each): Group N had no fluid resuscitation; Group L received lactated Ringer's solution infusion; and Group P received pyruvate Ringer's solution infusion. The survival rate was investigated after 24 h. In addition, a second set of 54 rats was selected for blood sampling, with identical methods for shock and resuscitation being followed, to determine arterial pH, blood gas analysis, lactate, pyruvate, and organs' enzyme activities at various time points. The MAP was monitored for 6 h in both populations.


RESULTS
Pyruvate Ringer's solution significantly increased the survival rate of rats subjected to fatal shock and receiving pyruvate Ringer's solution (Group P) by 1.5 times the survival rate in Group L at 24 h after fluid resuscitation (55.6% vs. 22.2%, respectively; p < 0.05). Pyruvate infusion maintained a higher MAP and fully corrected severe acidosis 1 h after resuscitation in comparison to the lactated infusion, and markedly decreased blood lactate levels and the lactate-to-pyruvate ratio 4 h after resuscitation. It also significantly improved serum markers of organ dysfunction.


CONCLUSIONS
Pyruvate Ringer's solution efficiently treated hypoxic lactic acidosis and significantly increased the survival rate in rats with lethal hemorrhagic shock. Pyruvate Ringer's solution is potentially applicable to clinical resuscitation in humans.
Laboratory of Shock and Organ Dysfunction, Burns Institute, First Hospital Affiliated to the PLA General Hospital, Beijing, China.
Sen
S
Hu
Xiao Dong
XD
Bai
Xian Qi
XQ
Liu
Hai Bin
HB
Wang
Yu Xian
YX
Zhong
Tiao
T
Fang
Fang Qiang
FQ
Zhou
D000140:Acidosis, Lactic / Q000188:drug therapy* / Q000209:etiology; D000704:Analysis of Variance; D000818:Animals; D062186:Arterial Pressure; D002245:Carbon Dioxide / Q000097:blood; D004195:Disease Models, Animal; D007552:Isotonic Solutions / Q000627:therapeutic use*; D019344:Lactic Acid / Q000097:blood; D008297:Male; D010100:Oxygen / Q000097:blood; D019289:Pyruvic Acid / Q000097:blood / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000077331:Ringer's Solution; D012771:Shock, Hemorrhagic / Q000150:complications* / Q000188:drug therapy
D007552:Isotonic Solutions; D002245:Carbon Dioxide; D019344:Lactic Acid; D000077331:Ringer's Solution; D019289:Pyruvic Acid; D010100:Oxygen
hemorrhagic shock; ischemic injury; lactate; lactated Ringer's solution; lactic acidosis; pyruvate; pyruvate Ringer's solution