Persistent reduced oxygen requirement following blood transfusion during recovery from hemorrhagic shock.
Our study intended to determine the effects on oxygen uptake (VO2) of restoring a normal rate of O2 delivery following blood transfusion (BT) after a severe hemorrhage (H). Spontaneously breathing urethane anesthetized rats were bled by removing 20 ml/kg of blood over 30 min. Rats were then infused with their own shed blood 15 min after the end of H. At mid-perfusion, half of the rats received a unique infusion of the decoupling agent 2,4-dinitrophenol (DNP, 6 mg/kg). VO2 and arterial blood pressure (ABP) were continuously measured throughout the study, along with serial determination of blood lactate concentration [La]. Animals were euthanized 45 min after the end of reperfusion; liver and lungs were further analyzed for early expression of oxidative stress gene using RT-PCR. Our bleeding protocol induced a significant decrease in ABP and increase in [La], while VO2 dropped by half. The O2 deficit progressively accumulated during the period of bleeding reached -114 ± 53 ml/kg, just before blood transfusion. Despite the transfusion of blood, a significant O2 deficit persisted (-82 ± 59 ml/kg) 45 min after reperfusion. This slow recovery of VO2 was sped up by DNP injection, leading to a fast recovery of O2 deficit after reperfusion, becoming positive (+460 ± 132 ml/kg) by the end of the protocol, supporting the view that O2 supply is not the main controller of VO2 dynamics after BT. Of note is that DNP also enhanced oxidative stress gene expression (up-regulation of NADPH oxidase 4 in the lung for instance). The mechanism of slow recovery of O2 requirement/demand following BT and the resulting effects on tissues exposed to relatively high O2 partial pressure are discussed.
Pennsylvania State University, College of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State Hershey Medical Center, 500 University Dr., Hershey, PO Box 850, Hershey, PA 17033, USA. Electronic address: phaouzi@hmc.psu.edu.
Philippe
P
Haouzi
Pennsylvania State University, College of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State Hershey Medical Center, 500 University Dr., Hershey, PO Box 850, Hershey, PA 17033, USA.
Andry
A
Van de Louw
D019297:2,4-Dinitrophenol / Q000008:administration & dosage / Q000493:pharmacokinetics; D000704:Analysis of Variance; D000818:Animals; D001794:Blood Pressure; D001803:Blood Transfusion / Q000379:methods*; D001831:Body Temperature / Q000502:physiology; D004396:Coloring Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D004195:Disease Models, Animal; D005786:Gene Expression Regulation / Q000235:genetics; D019255:NADPH Oxidases / Q000235:genetics / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism*; D010101:Oxygen Consumption / Q000235:genetics / Q000502:physiology; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function / Q000502:physiology*; D050794:STAT1 Transcription Factor / Q000378:metabolism; D012771:Shock, Hemorrhagic / Q000628:therapy*; D014691:Ventilation
D004396:Coloring Agents; D012333:RNA, Messenger; D050794:STAT1 Transcription Factor; C494081:Stat1 protein, rat; D019255:NADPH Oxidases; D019297:2,4-Dinitrophenol; D010100:Oxygen
Hemorrhagic shock; Mitochondria; Mitochondrial uncoupling; Oxygen consumption; Oxygen delivery