Chronic resuscitation after trauma-hemorrhage and acute fluid replacement improves hepatocellular function and cardiac output

Annals of Surgery
D E RemmersIrshad H Chaudry

Abstract

To determine whether prolonged (chronic) resuscitation has any beneficial effects on cardiac output and hepatocellular function after trauma-hemorrhage and acute fluid replacement. Acute fluid resuscitation after trauma-hemorrhage restores but does not maintain the depressed hepatocellular function and cardiac output. Male Sprague-Dawley rats underwent a 5-cm laparotomy (i.e., trauma was induced) and were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of maximal bleed-out volume was returned in the form of Ringer's lactate (RL). The animals were acutely resuscitated with RL using 4 times the volume of maximum bleed-out over 60 minutes, followed by chronic resuscitation of 0, 5, or 10 mL/kg/hr RL for 20 hours. Hepatocellular function was determined by an in vivo indocyanine green clearance technique. Hepatic microvascular blood flow was assessed by laser Doppler flowmetry. Plasma levels of interleukin-6 (IL-6) were determined by bioassay. Chronic resuscitation with 5 mL/kg/hr RL, but not with 0 or 10 mL/kg/hr RL, restored cardiac output, hepatocellular function, and hepatic microvascular blood flow at 20 hours after hemorrhage. The regimen above also reduced plasma IL-6 levels. Because chronic resuscitat...Continue Reading

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Citations

Feb 3, 2005·Journal of Neurotrauma·Gabriel Guízar-SahagúnEnrique Hong
Oct 12, 2004·American Journal of Physiology. Heart and Circulatory Physiology·Shaolong YangIrshad H Chaudry
Sep 18, 2002·American Journal of Physiology. Heart and Circulatory Physiology·Paul D MonganPushpa Sharma

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