Responsiveness to different volume therapies following hemodilution and hemorrhagic shock: a comparative experimental study in rats

Younes, Riad Naim; Deutsch, Fernanda; Itinoshe, M. M.; Fontes, Belchor; Poggetti, Renato Sérgio; Birolini, D

doi:10.1590/s0102-86502007000500006

Cited by 4 publications

(4 citation statements)

References 12 publications

(16 reference statements)

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“…Results of our study may be used to interpret or guide therapeutic procedures during severe bleeding and subsequent preoperative hemodilution 18 . Additionally, these results provide a broader basis for understanding the tolerance to hemorrhage after hemodilution, previously investigated in terms of the level of volume restitution and the effects of oxygen delivery capacity associated with the level of hemodilution 3‐6,41 …”

Section: Discussionmentioning

confidence: 77%

“…Moderate levels of colloidal plasma expansion and hemodilution up to approximately 50% exchange have no effects on FCD 2 . However if bleeding follows hemodilution the condition of the organism is significantly affected by the extent of hemodilution and volume loss, 3‐6 a situation described by Van der Linden and Vincent 5 as “tolerance of hemodiluted animals to hemorrhage.” This is an unusual clinical scenario; however, it can serve as an extreme model for the situation where hemorrhage is treated with plasma expanders and eventually with a blood transfusion. It should also evidence possible interactions between the type of colloid and blood used when these fluids are administered in sequence, which is a likely scenario.…”

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confidence: 99%

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Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage

et al. 2012

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BACKGROUND Treating hemorrhage with blood transfusions in subjects previously hemodiluted with different colloidal plasma expanders, using fresh autologous blood or 2-weeks stored blood, allows identifying the interaction between type of plasma expander and differences in blood storage. STUDY DESIGN AND METHODS Studies used the hamster window chamber model. Fresh autologous plasma, 130 kDa starch based plasma expander (HES), or 4% polyethylene glycol conjugated albumin (PEG-Alb) were used for 20% of blood volume hemodilution. Hemodilution was followed by a 55% by blood volume 40 min hemorrhagic shock period, treated with transfusion of fresh or 2-weeks stored blood. Outcome was evaluated one hour post blood transfusion in terms of microvascular and systemic parameters. RESULTS Results were principally dependent on the type of colloidal solution used during hemodilution, 4% PEG-Alb yielding the best microvascular recovery evaluated in terms of the functional capillary density. This result was consistent whether fresh blood or stored blood was used in treating the subsequent shock period. Fresh blood results were significantly better in systemic and microvascular terms relative to stored blood. HES and fresh plasma hemodilution yielded less favorable results, a difference that was enhanced when fresh vs. stored blood were compared in their efficacy of correcting the subsequent hemorrhage. CONCLUSION The type of plasma expander used for hemodilution influences the short term outcome of subsequent volume resuscitation using blood transfusion; 4% PEG-Alb providing the most favorable outcome by comparison to HES or fresh plasma.

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Section: Discussionmentioning

confidence: 77%

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confidence: 99%

Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage

et al. 2012

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“…Younes et al 49 performed a very extensive study with a rat model of hemorrhage, including 180 animals. Standard of care isotonic saline was compared to hypertonic saline and total blood retransfusion in a hemodilution model: they report that hypertonic saline is an effective and safe initial therapy for hemodiluted rats undergoing hemorrhagic shock, with an overall outcome comparable to blood replacement or high volume isotonic saline administration.…”

Section: Equivalencementioning

confidence: 99%

Hypertonic saline for treatment of shock: have we looked for everything?

Silva

2014

Medical Express

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This review is dedicated to the memory of Luis Poli de Figueiredo, who is responsible for much of what we know about small volume resuscitation. Small volume hypertonic resuscitation was originally based on the concept that a physiologically significant blood volume expansion follows the administration of a comparatively small volume of hypertonic fluid. Because hypertonicity is a physiological vasodilator, its use after severe blood loss induces reperfusion. Previously reported research disclosed a number of additional properties of hypertonic NaCl, amongst them (i) the correction of endothelial and red cell edema with significant consequences in terms of capillary blood flow; (ii) modulation of the immune system, with applications repercussions in the field of sepsis. This review covers developments in this field that occurred from 2005 through 2013. We discuss the discrepancy between animal experiments and human trials, and argue that the basic objective of most multicenter clinical trials may have been based upon a poor strategy.K EYWORDS: Shock; Hemorrhage; Sepsis Hypertonic saline; Immune circulation.Rocha-e-Silva M. Hypertonic saline for treatment of shock: have we looked for everything? MEDICALEXPRESS. 2014;1(1):14-21.

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“…[10,11] Studies of rats, dogs, swine, and pigs showed the relative efficacy of HTS fluid compared to normal saline (NS) for treating UHS. [12][13][14][15][16][17] Studies in the literature have proven the benefits of HTS in cases of brain and cord trauma. [18][19][20] Modeling UHS in animals can lead us to a definite decision on the optimal fluid therapy for UHS in humans.…”

Section: Introductionmentioning

confidence: 99%

Hypertonic, Normal Saline or Neither: Which One is better in Uncontrolled Hemorrhagic Shock? Experimental Study on Goat

Saeedi¹,

hajseyedjavadi²,

shamsvahdati³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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Responsiveness to different volume therapies following hemodilution and hemorrhagic shock: a comparative experimental study in rats

Abstract: Hypertonic saline is an effective and safe initial therapy for hemodiluted rats undergoing hemorrhagic shock, with an overall outcome comparable to blood replacement or high volume isotonic saline administration.

Cited by 4 publications

References 12 publications

Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage

Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage

Hypertonic saline for treatment of shock: have we looked for everything?

Hypertonic, Normal Saline or Neither: Which One is better in Uncontrolled Hemorrhagic Shock? Experimental Study on Goat

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