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Updated: Jul 29, 2026
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Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
Pyruvate improves cerebral metabolism during hemorrhagic shock
P D Mongan1, J Capacchione, J L Fontana
1Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. pmongan@usuhs.mil
Summary
Pyruvate (PYR) administration during hemorrhagic shock improved brain function and survival in swine. PYR stabilized cellular energy and reduced harmful metabolic byproducts, demonstrating its therapeutic potential for critical care.
Area of Science:
- Physiology
- Biochemistry
- Neuroscience
Background:
- Pyruvate (PYR) is known to enhance cellular and organ function during hypoxia and ischemia.
- It achieves this by stabilizing the reduced nicotinamide adenine dinucleotide (NADH) redox state and cytosolic ATP phosphorylation potential.
Purpose of the Study:
- To evaluate the effects of intravenous pyruvate on neocortical function in swine subjected to prolonged hemorrhagic shock.
- To assess pyruvate's impact on cellular energy state, redox state, and ischemia during controlled arterial hemorrhage.
Main Methods:
- A 4-hour controlled arterial hemorrhage model (40 mmHg) was used in swine.
- Sodium pyruvate (0.5 g x kg(-1) x h(-1)) was infused to achieve arterial levels of 5 mM.
- Control groups received 10% NaCl (hypertonic saline, HTS) or 0.9% NaCl (normal saline, NS) for volume and osmotic matching.
Main Results:
- Pyruvate administration significantly delayed the time to peak hemorrhage volume and improved survival rates (100% survival vs. 62.5% for HTS and 50% for NS).
- Pyruvate improved cerebral cortical metabolic and functional status, indicated by preserved ATP and phosphocreatine levels and a stable electrocorticogram.
- Pyruvate reduced the accumulation of adenosine, inosine, hypoxanthine, and prevented the rise in glutamate, an excitotoxic amino acid.
Conclusions:
- Intravenous pyruvate administered after the onset of hemorrhagic shock markedly improves cerebral metabolic and functional status in swine.
- Pyruvate demonstrates significant neuroprotective effects and enhances survival during prolonged hemorrhagic shock.
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