Intravenous Injection of Keratose Resuscitation Fluid (KRF) Restores Arteriolar Diameter in Striated Muscle of Hemorrhaged Rats

Whole blood is the best treatmenet for severe hemorrhage but it's not always accessible. Keratose has been proposed as a plasma expander. Keratose is highly osmotic which causes mobilization of water into the intravascular space. It's also highly viscous which induces release of vasodilators through shear stress on the endothelium. These effects could improve tissue perfusion and cardiac output and, reduce the amount of fluid infused. This study measured skeletal muscle vasculature reperfusing after hemorrhage with KRF. Methods Rats were instrumented with carotid and jugular catheters. Cremaster microvascular prep was used to measure arteriolar diameter. Subjects were bled 30% of total blood and given 20% back in the form of 6% Hetastarch Solution or 6.7% KRF solution. Measurements were done at baseline, post hemorrhage/resuscitation and up to 2 hours later. ANOVA was run to find differences in arteriolar diameter. Kaplan Meier analysis determined if survival improved in one group. Results KRF and Hetastarch had similar arteriolar recovery (p = 0.77). Survival in the KRF group was better but was not statistically significant (p = 0.22). The usage of a hyperviscous fluid in hemorrhagic shock derives from improved functional capillary density which has been shown to correlate with lower mortality rates post hemorrhage. Further work is required to measure hemodynamic parameters.