No abstract

The present study was designed to ascertain the effects of 3 diets with different omega-3/6 fatty acid ratios on infarct size and the modifications that these diets induce in the lipid composition of cardiac tissue. Sprague-Dawley rats were fed omega-3/6 fatty acid diets with 1:1, 1:5, or 1:20 ratios for at least 10 days, followed by occlusion of the left anterior descending artery for 40 min and 24 h of reperfusion. Infarct size was significantly smaller in the 1:1 group than in the other groups. Significantly higher concentrations of the omega-3 fatty acids eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid were found in the 1:1 group than in the other groups. Omega-6 polyunsaturated fatty acid levels were similar between groups, although they were higher in the 1:5 and 1:20 groups than in the 1:1 group. Margaric acid concentrations were higher in the 1:1 group than in the other groups. Docosahexaenoic acid levels in cardiac tissue and infarct size were significantly correlated with no other significant links being apparent. The present study indicated that a 1:1 omega-3/6 fatty acid ratio protected against ischemia and was associated with increased omega-3 fatty acid composition of cardiac tissue.

Background: Multi-organ failure is a consequence of severe ischemia-reperfusion injury after traumatic hemorrhagic shock, a major cause of mortality in trauma patients. Circulating uric acid, released from cell lysis, is known to activate pro-inflammatory and pro-apoptotic pathways and has been associated with poor clinical outcomes among critically ill patients. Our group has recently shown a mediator role for uric acid in kidney and lung injury, but its role in liver and enteric damage after hemorrhagic shock remains undefined. Therefore, the objective of this study was to evaluate the role of uric acid on liver and enteric injury after resuscitated hemorrhagic shock.Methods: A murine model of resuscitated hemorrhagic shock was treated during resuscitation with a recombinant uricase, a urate oxidase enzyme (rasburicase, Sanofi), to metabolize and reduce circulating uric acid. Biochemical analyses (liver enzymes, liver apoptotic and inflammatory markers) were performed at 24h and 72h after hemorrhagic shock. Physiological testing for enteric permeability and gut bacterial product translocation measurement (plasma endotoxin) were performed 72h after hemorrhagic shock. In vitro, HT-29 cells were exposed to UA, and the expression of intercellular adhesion proteins (ZO-1, e-cadherin) was measured to evaluate the influence of uric acid on enteric permeability.Results: The addition of Uricase to resuscitation significantly reduced circulating and liver uric acid levels after hemorrhagic shock. It also prevented hemorrhagic shock-induced hepatolysis and liver apoptotic/inflammatory mediators at 24h and 72h. Hemorrhagic shock-induced enteric hyperpermeability and endotoxemia were prevented with uricase.

Purpose Hypotension is common following spinal anesthesia (SA) during elective Cesarean delivery (CD). Although common practice is to alleviate inferior vena cava (IVC) compression, limited evidence supports a 15°t ilt for CD. We measured collapsibility of the IVC in supine and 15°left lateral tilt positions with ultrasound before and after SA and phenylephrine infusion in term parturients. Methods Twenty term parturients scheduled for CD were recruited for this prospective study. Ultrasound measurements of the IVC were taken 1) supine before SA, 2) tilted 15°before SA, 3) supine after SA, and 4) tilted 15°a fter SA. A phenylephrine infusion was begun after injection of SA. The primary outcome was to evaluate the impact of position on the IVC collapsibility index (IVCCI): a measure of the difference between the maximum and minimum IVC diameter with respiration. Results The mean (standard deviation) IVCCI (%) before SA was higher in the supine 19.5 (8.0) than in the tilted 15.0 (6.4) position