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Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock
Published on: June 6, 2011
Hypertonic saline resuscitation of hemorrhagic shock does not decrease in vivo neutrophil interactions with
Wanfeng Gong1, Joshua A Marks, Paymon Sanati
1Division of Traumatology, Surgical Critical Care & Emergency Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
The Journal of Trauma
|August 10, 2011
Summary
Hypertonic saline (HTS) resuscitation did not reduce polymorphonuclear neutrophil (PMN) and endothelial cell (EC) interactions in the brain's microcirculation, unlike in systemic circulation. This suggests HTS may activate brain PMN-EC crosstalk.
Area of Science:
- Neuroscience
- Physiology
- Critical Care Medicine
Background:
- Hemorrhagic shock resuscitation with isotonic crystalloids activates polymorphonuclear neutrophils (PMNs).
- Hypertonic saline (HTS) reduces PMN-endothelial cell (EC) interactions in systemic circulation.
- The effect of HTS on PMN-EC interactions within the blood-brain barrier microcirculation remains unknown.
Purpose of the Study:
- To investigate the hypothesis that HTS resuscitation blunts in vivo PMN-EC interactions in the brain's unique microcirculation.
- To compare the effects of HTS and Ringer's lactate (RL) on PMN-EC crosstalk in the pial microvasculature during hemorrhagic shock resuscitation.
Main Methods:
- Wistar rats underwent hemorrhagic shock and resuscitation with either HTS or RL.
- Intravital videomicroscopy was used to visualize and quantify PMN-EC interactions in pial venules.
- Hemodynamics and arterial gases were monitored throughout the experiment.
Main Results:
- Both HTS and RL groups developed metabolic acidosis post-hemorrhage.
- Post-resuscitation blood pressures were similar between groups.
- Contrary to expectations, HTS did not reduce PMN rolling and adhesion; RL showed trends of lower interactions.
Conclusions:
- HTS resuscitation may activate PMN-EC crosstalk in the blood-brain microcirculation, contrasting with systemic effects.
- Further research is required to elucidate the mechanisms behind this brain-specific effect.
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