title: The influence of Ringer's lactate or HES 130/0.4 administration on the integrity of the small intestinal mucosa in a pig hemorrhagic shock model under general anesthesia.
abstract: OBJECTIVE
  To determine the effect of fluid resuscitation with 2 different physiological solutions, Ringer's lactate (RL) and hydroxyethyl starch (HES) 130/0.4, on histological lesions of the small intestinal mucosa in anesthetized pigs subjected to severe acute bleeding.
  
  
  METHODS
  Prospective experimental study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Twenty-eight healthy Large White pigs, 3 months of age.
  
  
  METHODS
  Pigs were subjected to severe acute bleeding (30 mL/kg) under total intravenous anesthesia with propofol and remifentanil. Pigs were randomly allocated to 3 groups: Group 1 (n = 11) received RL solution (25 mL/kg) after bleeding; Group 2 (n = 11) received HES 130/0.4 solution (20 mL/kg) after bleeding; and Group 3 (n = 6) volume replacement nor induced bleeding. Pigs were euthanized and the small intestine was harvested for histopathological analysis.
  
  
  RESULTS
  The small intestine was histologically evaluated and the presence of the following lesions were characterized: edema, congestion, hyperemia, hemorrhage, inflammatory infiltration, cellular degeneration, necrosis, and epithelial detachment. Mucosal loss percentage (%ML) and crypt:interstitium ratio (C:I) were also assessed. In the duodenum, jejunum, and ileum, and the entire small intestine, the %ML was significantly higher in Group 1, than in Groups 2 and 3. Hyperemia in the small intestine was significantly higher in pigs resuscitated with HES 130/0.4 compared to pigs resuscitated with RL.
  
  
  CONCLUSIONS
  In a setting of controlled hemorrhage, resuscitation with HES 130/0.4 was associated with a lower percentage of mucosal loss on the small intestine, compared with resuscitation with RL solution. Our study also suggests that the duodenum may be more sensitive to hypovolemia induced by severe hemorrhage.
authors.affiliation: School of Veterinary Medicine, University of León, León, Spain.|Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Ana Liza
authors.initials: AL
authors.lastname: Ortiz
authors.affiliation: Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB) and Centre for Studies in Education and Health Technologies (CI&DETS) Agrarian Superior School of Viseu, Polytechnic Institute of Viseu, Viseu, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Vala
authors.affiliation: Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, Vila Real, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Venâncio
authors.affiliation: Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB) and Centre for Studies in Education and Health Technologies (CI&DETS) Agrarian Superior School of Viseu, Polytechnic Institute of Viseu, Viseu, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Mesquita
authors.affiliation: REQUIMTE, Faculty of Pharmacy, University of Porto, Portugal.
authors.forename: Aura
authors.initials: A
authors.lastname: Silva
authors.affiliation: School of Veterinary Medicine, University of León, León, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Gonzalo-Orden
authors.affiliation: CBIOS- Research Center for Biosciences & Health Technologies, University Lusófonal de Humanidades e Tecnologias, Lisbon, Portugal and Veterinary Medicine Department of University of Évora, Évora, Portugal.
authors.forename: David
authors.initials: D
authors.lastname: Ferreira
mesh_terms: D000768:Anesthesia, General / Q000662:veterinary; D000818:Animals; D004195:Disease Models, Animal; D005440:Fluid Therapy / Q000662:veterinary; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007262:Infusions, Intravenous / Q000662:veterinary; D007413:Intestinal Mucosa / Q000187:drug effects; D007421:Intestine, Small / Q000187:drug effects; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000188:drug therapy*; D013552:Swine; D016896:Treatment Outcome
chemical_list: C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D000077325:Ringer's Lactate
keywords: hypovolemia; intestinal mucosa injury; morphological assessment