Norepinephrine Decreases Fluid Requirements and Blood Loss While Preserving Intestinal Villi Microcirculation during Fluid Resuscitation of Uncontrolled Hemorrhagic Shock in Mice

Anesthesiology
Anatole HarroisJ Duranteau

Abstract

Norepinephrine administration is controversial during hemorrhagic shock resuscitation to stabilize mean arterial pressure (MAP) level because it could have deleterious effects on local circulations. The authors investigated the effect of norepinephrine on intestinal microcirculation during fluid resuscitation in uncontrolled hemorrhagic shock. Mice (n = 6 per group) submitted to an uncontrolled hemorrhagic shock by tail section were randomly assigned to a resuscitation with fluid but without norepinephrine to target a MAP level of 50 mmHg (FR50) or 60 mmHg (FR60) or a resuscitation with fluid and norepinephrine to target a MAP level of 50 mmHg (FRNE50) or 60 mmHg (FRNE60). Intestinal microcirculation was observed by intravital microscopy. Fluid requirements were lower in groups resuscitated with fluid and norepinephrine than in groups resuscitated with fluid without norepinephrine (74.6 ± 45.1 in FR50 vs. 28.1 ± 10.0 µl/g in FRNE50; P = 0.004 and 161.9 ± 90.4 in FR60 vs. 44.5 ± 24.0 µl/g in FRNE60; P = 0.041). Blood loss was not statistically different between FR50 and FRNE50 (14.8 ± 8.3 vs. 8.5 ± 2.9 µl/g; P = 0.180) but was significantly lower in FRNE60 than in FR60 (10.1 ± 4.2 vs. 22.6 ± 9.6 µl/g; P = 0.015). This beneficial...Continue Reading

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Citations

Mar 18, 2016·Journal of Intensive Care·Tsuneo Tatara
Apr 18, 2016·Seminars in Nephrology·Matthieu Legrand, Can Ince
Apr 14, 2016·Critical Care : the Official Journal of the Critical Care Forum·Rolf RossaintDonat R Spahn
Dec 20, 2017·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Simon Gelman, Luca Bigatello
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Feb 12, 2017·Der Internist·T I EibenS Kluge
Nov 14, 2018·Intensive Care Medicine Experimental·Sophie Dunberry-PoissantEmmanuel Charbonney
Aug 23, 2021·Critical Care : the Official Journal of the Critical Care Forum·Imane AddaXavier Monnet

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