Effects of fluid resuscitation with recombinant human serum albumin solution on maintaining hepatic energy metabolism in hemorrhagic shock rabbits.
The objective of this study was to examine the effects of volume replacement with recombinant human serum albumin (rHSA), which was developed to reduce the consumption of human blood derivatives, on maintaining hepatic energy metabolism. Hemorrhagic shock with a mean blood pressure of 50 mmHg was induced within 20 min and maintained for 60 min by Wiggars' method in rabbits. Fluid resuscitation replacing two thirds of the blood withdrawn with plasma-derived 5% human serum albumin (pHSA; n = 7) or rHSA (n = 10), or replacing double the volume of blood withdrawn with lactated Ringer's solution (n = 7) was completed within 20 min, and observed for 120 min. No significant differences were observed in the blood pressures, blood gas analyses, blood counts, biochemical parameters (e.g., alanine aminotransferase, lactate dehydrogenase, creatine kinase, blood urea nitrogen, creatinine) or blood glucose levels among the three groups. There were also no significant differences in the parameters of hepatic energy metabolism such as blood pyruvate and lactate levels and their ratios, ketone body concentrations and their ratios, and hepatic tissue energy charge levels among the experimental groups. It is suggested that volume replacement with rHSA, like pHSA, is able to maintain hemodynamics and organ function in hemorrhagic shock, particularly hepatic energy metabolism.