Effects of Different Resuscitation Fluids on Pulmonary Expression of Aquaporin1 and Aquaporin5 in a Rat Model of Uncontrolled Hemorrhagic Shock and Infection

Abstract

BackgroundTo investigate the effects of fluids resuscitation on pulmonary expression of aquaporin1 and aquaporin5 in a rat model of uncontrolled hemorrhagic shock and infection.MethodsSixty Sprague-Dawley rats were randomly assigned to five groups, sham operation group (Group C) and four treated groups: no fluid resuscitation group (Group NF), groups resuscitated with Lactated Ringer's (LR),7.5% NaCl (HTS) and Hydroxyl ethyl starch (HES) respectively. Three-phased uncontrolled hemorrhagic shock and infection model was used. Phase I: Massive hemorrhage with a mean arterial pressure of 35–40 mmHg for 60 min, and followed by infection of lipopolysaccharide. Then some animals were resuscitated with solutions mentioned above, until 90 min. Phase II: At hemorrhagic shock 90 minutes, phase II of 60 minutes began with hemostasis and returning of all the initial shed blood. Phase III: Observation phase for 3.5 hours. After phase III, arterial blood gas analysis and the survival rates of the rats were recorded, Wet-to-dry lung weight ratio, BALF protein, pulmonary permeability index, and expressions of aquaporin1 and aquaporin5 were tested.ResultsThe expressions of aquaporin1 and aquaporin5 were decreased in treatment groups comparing with sham operation group. Group HES and Group HTS decreased pulmonary vascular permeability and Wet-to-dry lung weight ratio, improved arterial blood gas analysis and survival rates, and attenuated the decreased pulmonary expression of aquaporin1 and aquaporin5 after the “two-hit”, comparing with groups NF and LR,but these beneficial effects were blunted in group HTS.ConclusionThe expression of aquaporin1 and aquaporin5 may play important roles in formation of pulmonary edema. Resuscitation with HTS and HES, especially HES can reduce lung injury after hemorrhagic shock, partly by up-regulating the expressions of aquaporin1 and aquaporin5.

Application of pulsed arterial resuscitation in a rabbit model of hemorrhagic shock

“…[13,15,17] Therefore, it is reasonable to believe that the application of pulsed arterial blood reinfusion may reduce early mortality in patients with hemorrhagic shock, while also having positive effects on the incidence of complications due to shock and late mortality. [13,28,29] In addition to rapidly increasing the effective circulating blood volume, arterial blood transfusion can pump the blood directly into the aorta, from where most of the blood is directly transported to various organs in need, particularly including the heart, brain, and kidneys; this process can rapidly improve the ischemic and hypoxic status of the body. [15,24] The direct supply of blood to the brain through the carotid tissues is beneficial to the recovery of vital medullary life functions, consequently improving the functioning of the central nervous system, especially that of the cortex and subcortical regions and thereby restoring the regulatory functions that were initially interfered with.…”

Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care

“…The effect of HES on pulmonary permeability has been the subject of numerous experimental and clinical investigations, using clinical, laboratory, and histological methods to assess pulmonary vascular leakage and edema formation, including pulmonary leak index, extravascular lung water, lung injury scores, arterial blood gas analyses, and wet‐to‐dry lung ratios . Most of these studies reported a positive effect of HES in decreasing pulmonary permeability .…”

“…However, these results may have been affected by the much larger volumes of crystalloids used, exacerbating pulmonary leakage . This is further supported by the fact that when noncolloidal low‐volume resuscitation agents, such as hypertonic saline (HTS), were included in the studies, they were found to produce similar pulmonary protective effects as HES . Clinical studies on major vascular surgery in people, in which pulmonary edema is a significant problem, have not endorsed findings of positive protective effects of HES .…”

Dopamine D1 receptor agonist A-68930 inhibits NLRP3 inflammasome activation and protects rats from spinal cord injury-induced acute lung injury

“…PPI and lung W/D were assessed on the basis of the method recorded by Gao et al 24 72 h after injury. The protein level in bronchoalveolar lavage fluid (BALF) and plasma was quantified by the Bicinchoninic Acid Protein Assay kit (Pierce, Rockford, IL, USA).…”