title: Deleterious effects of aggressive rapid crystalloid resuscitation on treatment of hyperinflammatory response and lung injury induced by hemorrhage in aging rats.
abstract: BACKGROUND
  Large-volume, rapid crystalloid infusion may increase endothelial cell damage and induce shear stress, potentially leading to multiple-organ dysfunction syndrome. Limited guideline data for fluid administration are currently available, especially for the aging population. The aim of the present study was to compare the degree of organ damage in conscious aging rats when different resuscitation speeds were used during the treatment of hemorrhagic shock (HS).
  
  
  METHODS
  Eighteen aging male Wistar-Kyoto rats were randomly divided into the following three groups: the control group, 30-min rapid resuscitation group, and 12-h slow resuscitation group. To mimic HS, 40% of the total blood volume was withdrawn. Fluid resuscitation (1:3) was given at 30 min after the blood withdrawal. Blood biochemical parameters including glucose, lactic acid, and lactate dehydrogenase (LDH) were measured along with the levels of serum and bronchoalveolar lavage fluid, tumor necrosis factor alpha (TNF-α), and interleukin 10 by enzyme-linked immunosorbent assay. The lungs were examined for pathologic changes, and the injury score at 24 h after HS was calculated.
  
  
  RESULTS
  Compared with slow-rate resuscitation, initially rapid and immediate resuscitation significantly increased the serum levels of glucose, LDH, and proinflammatory cytokines (TNF-α and interleukin 10), and bronchoalveolar lavage fluid levels of white blood cells, TNF-α, and LDH as well as produced pathologic changes in the organ. The lung injury scores were higher after induced HS in aging rats.
  
  
  CONCLUSIONS
  The slow and continuous (12 h) fluid resuscitation rate ameliorated HS-induced organ damage in conscious aging rats.
authors: Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
authors: Tzai-Chiu
authors: TC
authors: Yu
authors: Intensive Care Unit, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors: Fwu-Lin
authors: FL
authors: Yang
authors: Department of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
authors: Bang-Gee
authors: BG
authors: Hsu
authors: Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
authors: Wen-Tien
authors: WT
authors: Wu
authors: Department of Otolaryngology, Cheng Hsin Rehabilitation Medical Center, Taipei, Taiwan; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan.
authors: Szu-Chi
authors: SC
authors: Chen
authors: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
authors: Ru-Ping
authors: RP
authors: Lee
authors: Department of Nursing, Tzu Chi University, Hualien, Taiwan. Electronic address: eliyimch@mail.tcu.edu.tw.
authors: Yi-Maun
authors: YM
authors: Subeq
mesh_terms: D055371:Acute Lung Injury / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D000375:Aging; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001831:Body Temperature; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D000077324:Crystalloid Solutions; D005440:Fluid Therapy / Q000009:adverse effects* / Q000379:methods; D016753:Interleukin-10 / Q000097:blood; D007552:Isotonic Solutions / Q000494:pharmacology / Q000633:toxicity*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D008297:Male; D011897:Random Allocation; D051381:Rats; D011921:Rats, Inbred WKY; D012151:Resuscitation / Q000009:adverse effects* / Q000379:methods; D012771:Shock, Hemorrhagic / Q000150:complications / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D001786:Blood Glucose; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D019344:Lactic Acid; D007770:L-Lactate Dehydrogenase
keywords: Aging rat; Fluid resuscitation; Hemorrhagic shock; Organ damage