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Perflubron emulsion improves hepatic microvascular integrity and mitochondrial redox state after hemorrhagic shock.
- Source :
-
Shock (Augusta, Ga.) [Shock] 2003 Nov; Vol. 20 (5), pp. 449-57. - Publication Year :
- 2003
-
Abstract
- Hemorrhagic shock is associated with decreased systemic oxygen delivery, but also with impaired microvascular perfusion, which can result in diminished local oxygen availability even in the presence of adequate cardiac output after resuscitation. Beside surgical interventions to control blood loss, transfusion of stored packed red blood cells represents the current standard of care in the management of severe hemorrhagic shock. Because stored red blood cells are less deformable and show a higher O2 affinity that affects the O2 off-load to tissues, perfluorocarbon-based artificial oxygen carriers might improve local O2 delivery under these conditions. To test this, rats were subjected to hemorrhagic shock (1 h, mean arterial pressure [MAP] 30-35 mmHg) and were resuscitated with fresh whole blood, pentastarch, stored red blood cells, perflubron emulsion (2.7 and 5.4 g/kg body weight) together with pentastarch, or stored red blood cells together with 2.7 g/kg perflubron emulsion. Hepatic microcirculation, tissue oxygenation, and mitochondrial redox state were investigated by intravital microscopy. In addition, hepatocellular function and liver enzyme release were determined. After hemorrhagic shock and resuscitation with perflubron emulsion, volumetric sinusoidal blood flow was significantly increased compared with resuscitation with stored red blood cells. Furthermore, resuscitation with perflubron emulsion resulted in higher hepatic tissue PO2 and normalized mitochondrial redox potential, which was accompanied by lessened hepatocellular injury as well as improved liver function. These results indicate that, in this model of hemorrhagic shock, asanguineous fluid resuscitation with addition of perflubron emulsion is superior to stored blood or pentastarch alone with respect to increased local O2 availability on the cellular level. This effect is primarily due to improved restoration of hepatic microcirculatory integrity.
- Subjects :
- Acid-Base Equilibrium drug effects
Animals
Aspartate Aminotransferases blood
Aspartate Aminotransferases drug effects
Blood Flow Velocity drug effects
Blood Gas Analysis
Blood Pressure drug effects
Blood Substitutes pharmacology
Blood Transfusion
Erythrocyte Transfusion
Heart Rate drug effects
Hematocrit
Hemoglobins analysis
Hemoglobins drug effects
Hydrocarbons, Brominated
Hydrogen-Ion Concentration drug effects
Hydroxyethyl Starch Derivatives pharmacology
Indocyanine Green pharmacokinetics
Liver blood supply
Liver injuries
Male
Microcirculation drug effects
Microcirculation physiopathology
Microscopy, Fluorescence
Mitochondria metabolism
NAD analysis
NAD drug effects
Organometallic Compounds pharmacology
Oxidation-Reduction drug effects
Oxygen analysis
Partial Pressure
Phenanthrolines pharmacology
Plasma Substitutes pharmacology
Rats
Rats, Sprague-Dawley
Resuscitation methods
Shock, Hemorrhagic physiopathology
Fluorocarbons pharmacology
Liver drug effects
Mitochondria drug effects
Shock, Hemorrhagic therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1073-2322
- Volume :
- 20
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Shock (Augusta, Ga.)
- Publication Type :
- Academic Journal
- Accession number :
- 14560110
- Full Text :
- https://doi.org/10.1097/01.shk.0000090601.26659.87