Effects of Lactated Ringer’s Solutions on Human Leukocytes

Koustova, Elena; Stanton, Kathleen; Gushchin, Vadim; Alam, Hasan B.; Stegalkina, Svetlana; Rhee, Peter

doi:10.1097/00005373-200205000-00009

Cited by 68 publications

(43 citation statements)

References 28 publications

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“…Current standard pre-hospital treatment strategies utilize resuscitation fluids and blood products, with a range of potential intrinsic immunomodulating properties [3][4][5][6][7]. U.S. Navy special operations forces routinely use the low-volume colloid Hextend (HEX) for resuscitation of combat casualties as a hemodynamic bridge during evacuation and transport to definitive care.…”

Section: Introductionmentioning

confidence: 99%

Innate Immune Responses in Swine Resuscitated from Severe Traumatic Hemorrhagic Shock with Hemoglobin-Based Oxygen Carrier-201

Hall

Malkevich

Handrigan

et al. 2007

Artificial Cells, Blood Substitutes, and Biotechnology

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Hemoglobin-based oxygen carrier-201 transports oxygen and improves survival in swine with hemorrhagic shock, but has potential to be immune activating. Herein, we evaluated HBOC-201's immune effects in swine with more severe hemorrhagic shock due to soft tissue injury and 55% blood volume catheter withdrawal over 15 minutes followed by fluid resuscitation at 20 minutes with HBOC-201, Hextend, or no treatment (NON) before hospital arrival. Survival rates were similar with HBOC-201 and Hextend (p > 0.05), but were higher than in (p = 0.007). There were no significant group differences in blood cell count, percentages of leukocyte sub-populations and immunophenotype (CD4:CD8 ratio), adhesion markers expression (neutrophil CD11b; monocyte or neutrophil CD49d) and apoptosis. There was a trend to higher plasma IL-10 in HBOC-201 and groups vs. Hextend. We conclude that in swine with severe controlled HS and soft tissue injury, immune responses are similar with resuscitation with HBOC-201 and Hextend.

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Section: Introductionmentioning

confidence: 99%

Innate Immune Responses in Swine Resuscitated from Severe Traumatic Hemorrhagic Shock with Hemoglobin-Based Oxygen Carrier-201

Hall

Malkevich

Handrigan

et al. 2007

Artificial Cells, Blood Substitutes, and Biotechnology

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“…Administration of LR has been shown to activate neutrophils and upregulate the inflammatory response, though this is attenuated by the use of LR solutions that contain only the L-isomer of lactate. [26][27][28] In animal models, resuscitation with hypertonic saline has been demonstrated to lead to attenuated liver, pulmonary and intestinal inflammatory responses after hemorrhagic shock as compared with LR. [29][30][31] Similar findings have not been demonstrated for NS.…”

mentioning

confidence: 99%

The Impact of Pre-Hospital Administration of Lactated Ringer's Solution versus Normal Saline in Patients with Traumatic Brain Injury

Rowell

Fair

Barbosa

et al. 2016

Journal of Neurotrauma

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Lactated Ringer's (LR) and normal saline (NS) are both used for resuscitation of injured patients. NS has been associated with increased resuscitation volume, blood loss, acidosis, and coagulopathy compared with LR. We sought to determine if pre-hospital LR is associated with improved outcome compared with NS in patients with and without traumatic brain injury (TBI). We included patients receiving pre-hospital LR or NS from the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study. Patients with TBI (Abbreviated Injury Scale [AIS] head ‡3) and without TBI (AIS head £2) were compared. Cox proportional hazards models including Injury Severity Score (ISS), AIS head, AIS extremity, age, fluids, intubation status, and hospital site were generated for prediction of mortality. Linear regression models were generated for prediction of red blood cell (RBC) and crystalloid requirement, and admission biochemical/ physiological parameters. Seven hundred ninety-one patients received either LR (n = 117) or NS (n = 674). Median ISS, AIS head, AIS extremity, and pre-hospital fluid volume were higher in TBI and non-TBI patients receiving LR compared with NS ( p < 0.01). In patients with TBI (n = 308), LR was associated with higher adjusted mortality compared with NS (hazard rate [HR] = 1.78, confidence interval [CI] 1.04-3.04, p = 0.035). In patients without TBI (n = 483), no difference in mortality was demonstrated (HR = 1.49, CI 0.757-2.95, p = 0.247). Fluid type had no effect on admission biochemical or physiological parameters, 6-hour RBC, or crystalloid requirement in either group. LR was associated with increased mortality compared with NS in patients with TBI. These results underscore the need for a prospective randomized trial comparing pre-hospital LR with NS in patients with TBI.

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“…Normally, the D-and L-isoforms of lactate are both present in the racemic RL classically administered to patients in shock. The pro-inflammatory properties of RL have been attributed to the D-isomer of lactate, as neutrophil activation does not occur upon exposure to RL composed strictly of the Lisomer (41). This modification, however, does not circumvent the second major disadvantage of isotonic fluid resuscitation, namely the extended amount of ischemic time that elapses while administering the large infusion volumes necessary to achieve adequate perfusion.…”

Section: Discussionmentioning

confidence: 99%

Pentoxifylline-supplemented resuscitation attenuates both early and late mediators of hepatic inflammation after hemorrhagic shock

Deree

Loomis

Putnam

et al. 2008

Journal of Organ Dysfunction

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Objective. After hemorrhage, resuscitation with racemic Ringer's lactate (RL) results in hepatic injury and an increase in proinflammatory mediator synthesis. The aim of this study was to determine the effect of resuscitation including pentoxifylline (PTX) on mediators of hepatic inflammation after hypovolemic shock. Material and methods. Male SpragueÁDawley rats underwent 1 h of hypotension followed by resuscitation with RL or RL'PTX (25 mg/kg). Liver sections were scored for injury histologically. Nitric oxide and pro-inflammatory cytokines were measured using an enzyme-linked immunosorbent assay. Inducible nitric oxide synthase (iNOS) and high mobility group box 1 (HMGB1) content were evaluated by means of Western blotting. Results. In the presence of PTX, histologic hepatic injury was markedly less than with RL resuscitation (pB0.05). Furthermore, the addition of PTX to RL significantly attenuated the hepatic concentrations of tumor necrosis factor-a, interleukin (IL)-1b, IL-6, iNOS, NO and HMGB1 (pB0.05). Conclusion. PTX-supplemented resuscitation effectively attenuates RL-induced hepatic injury after hemorrhagic shock through downregulation of both early and late mediators of inflammation.

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Effects of Lactated Ringer’s Solutions on Human Leukocytes

Abstract: Lactated Ringer's solution in commonly used formulation (racemic mixture, DL-LR) influences neutrophil function and leukocyte gene expression.

Cited by 68 publications

References 28 publications

Innate Immune Responses in Swine Resuscitated from Severe Traumatic Hemorrhagic Shock with Hemoglobin-Based Oxygen Carrier-201

Innate Immune Responses in Swine Resuscitated from Severe Traumatic Hemorrhagic Shock with Hemoglobin-Based Oxygen Carrier-201

The Impact of Pre-Hospital Administration of Lactated Ringer's Solution versus Normal Saline in Patients with Traumatic Brain Injury

Pentoxifylline-supplemented resuscitation attenuates both early and late mediators of hepatic inflammation after hemorrhagic shock

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