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Microcirculatory responses to hypovolemic shock following resuscitation with Ringer’s solutions.
Author(s) -
Mielniczuk Mariusz,
Krokowicz Lukasz,
Kusza Krzysztof,
Siemionow Maria
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.6.a1236-b
Subject(s) - resuscitation , medicine , shock (circulatory) , anesthesia , perfusion , microcirculation , ringer's solution , extravasation , hemodynamics , blood volume , laser doppler velocimetry , blood flow , pathology
AIM OF STUDY: To evaluate impact of volume replacement with Ringer’s acetate and lactate solutions following induction of hypovolemic shock (HS). METHODS: Rat cremaster model was used to evaluate in vivo microcirculatory changes after induction of HS by withdrawal of 15% of total blood volume corresponding to decreasing MAP from basal 82.9 ( ± 6.76 ) mmHg to 47.8 ( ± 3.6 ) mmHg after HS. Rats were randomized into 4 groups of 10 each. 1) control, microcirculatory measurements for 4h; 2) HS without replacement; 3) HS with Ringer’s acetate replacement; 4) HS with Ringer’s lactate replacement. During 4h microcirculatory measurements of RBC velocity, vessel diameter, functional capillary perfusion ( FCP ) and leukocyte‐endothelial interactions where recorded. Endothelial micropermeability (EMP) was evaluated after 4h on FITC‐albumin extravasation by immunofluorescence image analysis at 15min intervals for 1h after reperfusion. EMP was calculated as interstitial/intraluminal pixels ratio. RESULTS: At 4h Ringer’s resuscitation group 3,4 showed 66% return of FCP compared to 33% in HS group. Ringer acetate resuscitation reduced significantly (P<0.001) level of sticking and transmigrated PMN’s compared to HS group without treatment. CONCLUSIONS: Ringers resuscitation improved significantly microcirculatory hemodynamic in groups (3,4) however never returned to pre‐shock values.