Pyruvate Is Superior to Reverse Visceral Hypoperfusion in Peritoneal Resuscitation From Hemorrhagic Shock in Rats

Abstract

Peritoneal resuscitation with hyperosmolar fluids attenuated visceral vasoconstriction and splanchnic hypoperfusion and improved the intestinal barrier protein and organ function following conventional fluid resuscitation from severe HS in rats. Pyruvate was superior to lactate in PDS as PR fluids, and 2.2% pyruvate was the optimal fluid in PR.

Effect of Intraperitoneal Resuscitation With Different Concentrations of Sodium Pyruvate on Intestinal Ischemia Reperfusion Injury in Hemorrhagic Shock Rat

“…Even though we did not observe splanchnic blood flow and survival rate in this study, other studies have already confirmed that the administration of PR using solutions containing pyruvate could significantly improve those indexes (13,14). Compared with lactate-based peritoneal dialysis solution, PR fluid of pyruvate showed significant protective advantages on its protective effect in cells and organs.…”

“…Zakaria et al attributed the beneficial effects of PR to the hypertonicity and the contained glucose of the peritoneal dialysis fluid used (5,6). Hu et al compared two kinds of dialysate containing pyruvate with commonly used 2.5% Lac-PDS in an experimental design that excluded the impact of the osmotic pressure (14). Their results showed PY had significant advantages for visceral protection, especially for the small intestine.…”

“…Pyruvate has protective effects on intestinal mucosal ischemia-reperfusion injury (15,21). When administering fluid resuscitation in HS, the addition of PR using pyruvate solution to VR can effectively inhibit the inflammatory response, scavenge oxygen-free radicals, protect the intestinal mucosal barrier, reduce intestinal ischemia-reperfusion injury following resuscitation, and prevent the occurrence of MODS (12)(13)(14). Zakaria et al attributed the beneficial effects of PR to the hypertonicity and the contained glucose of the peritoneal dialysis fluid used (5,6).…”

“…Hu Sen and his colleagues provided rats with PR fluids of the same hypertonicity, and they found that PR using simple 2.2% sodium pyruvate (PY) solution had better outcomes than pyruvate dialysate (14). To follow up on this, we wonder whether 2.2% PY is the best concentration.…”

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

“…[18,19] However, a sudden influx of liquid into the blood vessels will cause the infused blood to be retained in the venous system as the blood is in a state of stasis in the capillaries, which will cause a constant increase in the intravascular hydrostatic pressure. [13,[20][21][22] In turn, this results in more intravascular liquid penetrating into the extravascular space through the blood vessel walls, which already show increased permeability due to the ischemic and hypoxic injury.…”