Post-hemorrhagic shock mesenteric lymph is an important contributor to cardiac dysfunction following hemorrhagic shock

Abstract

PURPOSE:To evaluate whether post-hemorrhagic shock mesenteric lymph (PSML) is involved in cardiac dysfunction induced by hemorrhagic shock. METHODS:The hemorrhagic shock model (40±2 mmHg, 3h) was established in rats of the shock and shock+drainage groups; and PSML drainage was performed from hypotension 1-3h in the shock+drainage rats. Then, the isolated hearts were obtained from the rats for the examination of cardiac function with Langendorff system. Subsequently, the isolated hearts were obtained from normal rats and perfused with PSML or Krebs-Henseleit solution, and the changes of cardiac function were observed. RESULTS:The left ventricular systolic pressure (LVSP) and the maximal rates of LV developed pressure (LVDP) rise and fall (±dP/ dt max ) in the shock and shock+drainage groups were lower than that of the sham group; otherwise, these indices in the shock+drainage group were higher compared to the shock group. In addition, after isolated hearts obtained from normal rats perfusing with PSML, these cardiac function indices were gradual decline along with the extension of time, such as heart rate, LVSP, ±dP/dt max , etc. CONCLUSION:Post-hemorrhagic shock mesenteric lymph is an important contributor to cardiac dysfunction following hemorrhagic shock.

Mesenteric lymph drainage alleviates hemorrhagic shock-induced spleen injury and inflammation

“…The return of post-hemorrhagic shock mesenteric lymph (PHSML) is a key reason of multiple organ dysfunction caused by hemorrhagic shock. Therefore, mesenteric lymph drainage or mesenteric lymph duct ligation improve the multiple organ functions and reduce the tissue injury following hemorrhagic shock, such as lung, heart and kidney 4 – 10 . Recently, the role of PHSML in the pathogenesis of hemorrhagic shock has attracted increasing attention 11 – 13 .…”

Mesenteric Lymph Drainage Improves Cardiac Papillary Contractility and Calcium Sensitivity in Rats with Hemorrhagic Shock

“…[16][17][18][19] CaM is a key factor for the regulation of myocardial cell contraction, and insufficient CaM is one of the main mechanisms responsible for myocardial dysfunction and calcium desensitization in cardiomyocytes. 20 , 21 Since PHSML return is a primary cause for hemorrhagic shock-induced myocardial systolic dysfunction, [9][10][11] the present study firstly observed the effects of MLDL and PHSML drainage on CaM expression in papillary muscles. We found that hemorrhagic shock decreased the expression of CaM in papillary muscles, which was reversed by blockade of PHSML return.…”

“…By contrast, administration of PHSML to healthy rats causes decreases in left ventricular systolic pressure and the ±dP/dtmax of isolated heart pump functions. 9 Moreover, MLDL enhances myocardial contraction function and sensitivity of the heart to gradient calcium ion 10 , while intravenous injection of PHSML into immature rats causes myocardial contraction dysfunction. 11 Therefore, PHSML return is a critical factor to regulate the pump function of heart after hemorrhagic shock.…”

Mechanisms Involved in Secondary Cardiac Dysfunction in Animal Models of Trauma and Hemorrhagic Shock

“…an initial dose dependent inotropic effect immediately after exposure, which was followed by progressive loss of contractile function (31). A recent study revealed a reduction in cardiac contractile dysfunction following H-S in animals subject to mesenteric lymph drainage (65). The lymph studied was sterile and contained similar levels of cytokines when compared to lymph from control animals, thereby suggesting a role for ALARMIN and DAMP type molecules in the process (31,32).…”