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Comparison of plasma and 5% albumin resuscitation on preserving endothelial glycocalyx and microvascular permeability in vivo after severe hemorrhagic shock in rats (676.12)
Author(s) -
Torres Luciana,
Sondeen Jill,
Salgado Christi,
Dubick Michael,
Torres Filho Ivo
Publication year - 2014
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.28.1_supplement.676.12
Subject(s) - resuscitation , albumin , medicine , hemodynamics , vascular permeability , fresh frozen plasma , hetastarch , perfusion , blood flow , glycocalyx , anesthesia , platelet , immunology
Plasma expanders have been used to promote volume replacement and improve hemodynamics and tissue perfusion after HS. We have investigated the effects of high viscosity plasma expanders on the EG of cremaster muscle venules from anesthetized rats subjected to 40% HS for 1h followed by 1h resuscitation with 5% albumin (ALB, Buminate), fresh frozen plasma (FFP) or 6% Hetastarch (HEX, Hextend). EG thickness, blood flow, and permeability were studied using intravital microscopy. Hemodynamics and coagulation tests (ROTEM) were measured. Mean arterial pressure was significantly lower than baseline for all groups (hypotensive resuscitation). HEX group showed significantly lower EG thickness, higher blood flow and permeability than the FFP. ALB partially restored EG thickness (80% of baseline), but showed higher blood flow and shear rate than the FFP group (p<0.05). Permeability was 20% higher in the ALB group than baseline. EXTEM and FIBTEM showed higher clotting time and lower clot strength in the ALB and HEX groups compared to FFP. In conclusion, resuscitation with ALB alone is not sufficient to return the EG thickness, permeability and coagulation to normal after HS possibly due to the lack of other plasma components beyond that of albumin. Resuscitation with FFP is superior to high viscosity plasma expanders, including the main FFP protein constituent alone. Supported by US Army Medical Research & Materiel Command.