Sodium pyruvate is better than sodium chloride as a resuscitation solution in a rodent model of profound hemorrhagic shock

Slovin, Paul N; Huang, Chengwei; Cade, J. R.; Wood, Charles E.; Nasiroglu, Omer; Privette, Malcolm; Orbach, Pini; Skimming, Jeffrey W.

doi:10.1016/s0300-9572(01)00325-2

Cited by 40 publications

(23 citation statements)

References 28 publications

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“…Our data also indicate that this dose of SP increases arterial pyruvate levels for only 30 to 45 min, with concomitant rapid increases in arterial lactate (from 10 to 75 min post-injection) and a slow but steady increase in arterial glucose concentrations occurring over a 75 min period after SP injection. These findings contrast with a report indicating that intraperitoneally administered SP did not alter blood pH or plasma glucose (Gonzalez-Falcon et al, 2003), but are consistent with the finding that intravenously administered pyruvate increases arterial pH and serum bicarbonate (Mongan et al, 1999(Mongan et al, , 2001 and that elevations in serum pyruvate lead to rapidly increasing lactate concentrations, with more delayed increases in serum glucose concentrations ( Mongan et al, 1999( Mongan et al, , 2001Slovin et al, 2001;Gonzalez et al, 2005). The increased arterial lactate levels after SP treatment in sham and CCI conditions likely reflect peripheral metabolism (circulating LDH activity or hepatic metabolism), with conversion of injected pyruvate to lactate.…”

Section: Physiological and Metabolic Effects Of CCI And Sp Treatmentsupporting

confidence: 64%

“…In vivo studies in models of hemorrhagic shock have reported that intravenous infusion of solutions containing sodium pyruvate (SP) improved multiple cerebral energetic parameters, prevented hemorrhage-induced reductions in NAD þ and PARP cleavage, attenuated lipid peroxidation, and improved survival rates (Mongan et al, 1999(Mongan et al, , 2001Slovin et al, 2001). The majority of in vivo studies on exogenous SP treatment, however, have been conducted in rodents and administered SP via the intraperitoneal (i.p.)…”

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confidence: 99%

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Metabolic and Histologic Effects of Sodium Pyruvate Treatment in the Rat after Cortical Contusion Injury

Fukushima

Lee

Moro

et al. 2009

Journal of Neurotrauma

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This study determined the effects of intraperitoneal sodium pyruvate (SP) treatment on the levels of circulating fuels and on cerebral microdialysis levels of glucose (MD glc ), lactate (MD lac ), and pyruvate (MD pyr ), and the effects of SP treatment on neuropathology after left cortical contusion injury (CCI) in rats. SP injection (1000 mg=kg) 5 min after sham injury (Sham-SP) or CCI (CCI-SP) significantly increased arterial pyruvate ( p < 0.005) and lactate ( p < 0.001) compared to that of saline-treated rats with CCI (CCI-Sal). Serum glucose also increased significantly in CCI-SP compared to that in CCI-Sal rats ( p < 0.05), but not in Sham-SP rats. MD pyr was not altered after CCI-Sal, whereas MD lac levels within the cerebral cortex significantly increased bilaterally ( p < 0.05) and those for MD glc decreased bilaterally ( p < 0.05). MD pyr levels increased significantly in both Sham-SP and CCI-SP rats ( p < 0.05 vs. CCI-Sal) and were higher in left=injured cortex of the CCI-SP group ( p < 0.05 vs. sham-SP). In CCI-SP rats the contralateral MD lac decreased below CCI-Sal levels ( p < 0.05) and the ipsilateral MD glc levels exceeded those of CCI-Sal rats ( p < 0.05). Rats with a single low (500 mg=kg) or high dose (1000 mg=kg) SP treatment had fewer damaged cortical cells 6 h post-CCI than did saline-treated rats ( p < 0.05), but three hourly injections of SP (1000 mg=kg) were needed to significantly reduce contusion volume 2 weeks after CCI. Thus, a single intraperitoneal SP treatment increases circulating levels of three potential brain fuels, attenuates a CCI-induced reduction in extracellular glucose while increasing extracellular levels of pyruvate, but not lactate, and can attenuate cortical cell damage occurring within 6 h of injury. Enduring (2 week) neuronal protection was achieved only with multiple SP treatments within the first 2 h post-CCI, perhaps reflecting the need for additional fuel throughout the acute period of increased metabolic demands induced by CCI.

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Section: Physiological and Metabolic Effects Of CCI And Sp Treatmentsupporting

confidence: 64%

mentioning

confidence: 99%

Metabolic and Histologic Effects of Sodium Pyruvate Treatment in the Rat after Cortical Contusion Injury

Fukushima

Lee

Moro

et al. 2009

Journal of Neurotrauma

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“…During hemorrhagic shock, reductions in tissue blood flow and oxygen delivery cause a marked depletion of cellular energy, and alternate metabolic pathways are induced providing limited amounts of adenosine triphosphate by anaerobic glycolysis (21). Recent reports suggest that infused pyruvate can improve cellular metabolism, decrease organ damage, and improve survival during hemorrhagic shock (6,9,21,22).…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports suggest that infused pyruvate can improve cellular metabolism, decrease organ damage, and improve survival during hemorrhagic shock (6,9,21,22). Pyruvate can also act as a positive inotrope, may improve cardiac output, and prevent early reperfusion contractile failure after ischemic events (23,24).…”

Section: Discussionmentioning

confidence: 99%

“…Slovin et al (21) reported a superior hemodynamics and a higher survival rate after 1-h resuscitation of rats in severe hemorrhagic shock that were treated with a 1.7% sodium pyruvate solution in comparison with a control group resuscitated with a isosmolar 0.9% sodium chloride solution. They speculated that high levels of pyruvate became the preferred substrate for oxidative metabolism during shock, permitting the animals to remain in a state of hyperglycemia and maintaining reserves of hepatic glycogen.…”

Section: Discussionmentioning

confidence: 99%

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Hypertonic 15% Sodium Pyruvate Offers No Initial Resuscitation Advantage Compared With 8% Hypertonic Nacl in Sheep With Multiple Hemorrhages

Nascimento

Vaid

Hoskins

et al. 2007

Shock

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Initial fluid resuscitation of hemorrhagic shock might be enhanced by the infusion of monocarboxylate-energy substrates. We evaluated hemodynamics, metabolism, and fluid dynamics for initial resuscitation of hemorrhage using small volume 15% sodium pyruvate solution (HPY) compared with osmotically matched 8% hypertonic saline (HS). Instrumented conscious sheep were hemorrhaged 25 mL/kg at time zero through 15 min (T0-T15) and 5 mL/kg for 5 min at T50 to T55 and T70 to T75. Fluid resuscitation from T30 to T180 was performed by a computer-controlled closed-loop system, which titrated infusion rate to a mean arterial pressure of 90 mmHg. Initial infusion was 4 mL/kg of either HPY or HS, followed by the administration of lactated Ringer. Both HPY and HS restored cardiac index similarly. The lactate/pyruvate ratio was used to assess metabolic debt and was significantly higher (T180), whereas oxygen delivery was significantly lower (T120) with HPY versus HS. Total fluid administered was similar, with 43.7 +/- 6.2 mL/kg for HPY and 39.4 +/- 6.8 mL/kg for HS. Plasma volume was similarly increased and approached baseline values for both groups. Initial resuscitation with small volume HPY offered no hemodynamic or metabolic advantage compared with small volume HS when the fluids were infused to an end point pressure.

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Beneficial Effects of Ethyl Pyruvate in Septic Shock From Peritonitis

Su¹

2007

Arch Surg

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Sodium pyruvate is better than sodium chloride as a resuscitation solution in a rodent model of profound hemorrhagic shock

Cited by 40 publications

References 28 publications

Metabolic and Histologic Effects of Sodium Pyruvate Treatment in the Rat after Cortical Contusion Injury

Metabolic and Histologic Effects of Sodium Pyruvate Treatment in the Rat after Cortical Contusion Injury

Hypertonic 15% Sodium Pyruvate Offers No Initial Resuscitation Advantage Compared With 8% Hypertonic Nacl in Sheep With Multiple Hemorrhages

Beneficial Effects of Ethyl Pyruvate in Septic Shock From Peritonitis

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