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PubMed1994

Allopurinol plus standard resuscitation preserves hepatic blood flow and function following hemorrhagic shock.

To determine the contribution of ischemia-reperfusion injury (IRI) to the blood flow deficit and hepatocellular dysfunction seen after resuscitation from hemorrhagic shock, the xanthine oxidase inhibitor allopurinol was given to rats as a 50 mg/kg bolus after shock but before resuscitation and continued as a 25 mg/kg/h infusion. Resuscitation with shed blood and lactated Ringer's restored cardiac output and blood pressure in both groups. Control animals demonstrated a reduction in total hepatic and effective hepatic blood flow to 59% and 43% of baseline values, respectively. Allopurinol resulted in a return to baseline values of both variables. Allopurinol treatment resulted in a 350% increase in xanthine, a 630% increase in hypoxanthine, and a 70% reduction in uric acid concentrations. These data suggest that IRI contributes to the organ dysfunction and blood flow deficits seen after resuscitated hemorrhagic shock the effect of which can be attenuated by the addition of the xanthine oxidase inhibitor allopurinol to standard resuscitation.

Adenosine Triphosphate↗

PubMed1991

Cerebrovascular effects of small volume resuscitation from hemorrhagic shock: comparison of hypertonic saline and concentrated hydroxyethyl starch in dogs.

To determine if hypertonic and hyperoncotic resuscitation solutions exerted comparable effects on cerebral hemodynamics following hemorrhagic shock, we compared randomly assigned, equal volumes (6.0 ml/kg) of hypertonic (7.2%) saline (HS) and hyperoncotic (20%) hydroxyethyl starch (HES) for resuscitation from acute experimental hemorrhage in 12 anesthetized dogs. Regional cerebral blood flow (radiolabeled microspheres), intracranial pressure (cisternal catheter), and systemic hemodynamics were recorded. Rapid hemorrhage reduced the mean arterial pressure to 45 mm Hg for 30 min. Resuscitation fluids were infused over 5 min. Both fluids restored mean arterial pressure and cardiac output equally. However, at 60 min following resuscitation, cardiac output decreased in the HS group in comparison to the HES group (1.7 +/- 0.1 vs. 3.1 +/- 0.2 L/min, p <0.05). Cardiac output rapidly declined, however, in the HS group in comparison to the HES group (p <0.05 60 min following resuscitation). Intracranial pressure and cerebral perfusion pressure were similar at all intervals. Regional cerebral blood flow was similar following both fluids. Neither fluid restored cerebral oxygen transport to baseline values. Based on these data, the authors conclude that, following severe hemorrhagic shock of brief duration, systemic and cerebral hemodynamic values are restored equally well by highly concentrated colloid or by hypertonic saline, although hypertonic saline only transiently improves cardiac output.

Journal Article↗

PubMed2006

Resuscitation with normal saline (NS) vs. lactated ringers (LR) modulates hypercoagulability and leads to increased blood loss in an uncontrolled hemorrhagic shock swine model.

BACKGROUND: Lactated ringers (LR) and normal saline (NS) are used interchangeably in many trauma centers. The purpose of this study was to compare the effects of LR and NS on coagulation in an uncontrolled hemorrhagic swine model. We hypothesized resuscitation with LR would produce hypercoagulability. METHODS: There were 20 anesthetized swine (35 +/- 3 kg) that underwent central venous and arterial catheterization, celiotomy, and splenectomy. After splenectomy blinded study fluid equal to 3 mL per gram of splenic weight was administered. A grade V liver injury was made and animals bled without resuscitation for 30 minutes. Animals were resuscitated with the respective study fluid to, and maintained, at the preinjury MAP until study end. Prothrombin Time (PT), Partial Thromboplastin Time (PTT), and fibrinogen were collected at baseline (0') and study end (120'). Thrombelastography was performed at 0'and postinjury at 30', 60', 90', and 120'. RESULTS: There were no significant baseline group differences in R value, PT, PTT, and fibrinogen. There was no significant difference between baseline and 30 minutes R value with NS (p = 0.17). There was a significant R value reduction from baseline to 30 minutes with LR (p = 0.02). At 60 minutes, R value (p = 0.002) was shorter while alpha angle, maximum amplitude, and clotting index were higher (p < 0.05) in the LR versus the NS group. R value, PT, and PTT were significantly decreased at study end in the LR group compared with the NS group (p < 0.05). Overall blood loss was significantly higher in the NS versus LR group (p = 0.009). CONCLUSIONS: This data indicates that resuscitation with LR leads to greater hypercoagulability and less blood loss than resuscitation with NS in uncontrolled hemorrhagic shock.

Animals↗

PubMed2002

Resuscitation of Salmonella enterica serovar typhimurium and enterohemorrhagic Escherichia coli from the viable but nonculturable state by heat-stable enterobacterial autoinducer.

Salmonella enterica serovar Typhimurium and enterohemorrhagic Escherichia coli were stressed by prolonged incubation in water microcosms until it was no longer possible to observe colony formation when samples were plated on nonselective medium. Overnight incubation of samples in nutrient-rich broth medium supplemented with growth factors, however, allowed resuscitation of stressed and viable but nonculturable cells so that subsequent plating yielded observable colonies for significantly extended periods of time. The growth factors were (i) the trihydroxamate siderophore ferrioxamine E (for Salmonella only), (ii) the commercially available antioxidant Oxyrase, and (iii) the heat-stable autoinducer of growth secreted by enterobacterial species in response to norepinephrine. Analysis of water microcosms with the Bioscreen C apparatus confirmed that these supplements enhanced recovery of cells in stressed populations; enterobacterial autoinducer was the most effective, promoting resuscitation in populations that were so heavily stressed that ferrioxamine E or Oxyrase had no effect. Similar results were observed in Bioscreen analysis of bacterial populations stressed by heating. Patterns of resuscitation of S. enterica serovar Typhimurium rpoS mutants from water microcosms and heat stress were qualitatively similar, suggesting that the general stress response controlled by the sigma(s) subunit of RNA polymerase plays no role in autoinducer-dependent resuscitation. Enterobacterial autoinducer also resuscitated stressed populations of Citrobacter freundii and Enterobacter agglomerans.

Culture Media↗

PubMed2005

Mutants of Mycobacterium tuberculosis lacking three of the five rpf-like genes are defective for growth in vivo and for resuscitation in vitro.

Mycobacterium tuberculosis contains five genes, rpfA through rpfE, that bear significant homology to the resuscitation-promoting factor (rpf) gene of Micrococcus luteus, whose product is required to resuscitate the growth of dormant cultures of M. luteus and is essential for the growth of this organism. Previous studies have shown that deletion of any one of the five rpf-like genes did not affect the growth or survival of M. tuberculosis in vitro. In conjunction with the results of whole-genome expression profiling, this finding was indicative of their functional redundancy. In this study, we demonstrate that the single deletion mutants are phenotypically similar to wild-type M. tuberculosis H37Rv in vivo. The deletion of individual rpf-like genes had no discernible effect on the growth or long-term survival of M. tuberculosis in liquid culture, and the ability to resuscitate spontaneously from a nonculturable state in a most probable number assay was also unaffected for the three strains tested (the DeltarpfB, DeltarpfD, and DeltarpfE strains). In contrast, two multiple strains, KDT8 (DeltarpfA-mutation DeltarpfC DeltarpfB) and KDT9 (DeltarpfA DeltarpfC DeltarpfD), which lack three of the five rpf-like genes, were significantly yet differentially attenuated in a mouse infection model. These mutants were also unable to resuscitate spontaneously in vitro, demonstrating the importance of the Rpf-like proteins of M. tuberculosis in resuscitation from the nonculturable state. These results strongly suggest that the biological functions of the five rpf-like genes of M. tuberculosis are not wholly redundant and underscore the potential utility of these proteins as targets for therapeutic intervention.

Animals↗

PubMed2000

Mild resuscitative hypothermia to improve neurological outcome after cardiac arrest. A clinical feasibility trial. Hypothermia After Cardiac Arrest (HACA) Study Group.

BACKGROUND AND PURPOSE: Recent animal studies showed that mild resuscitative hypothermia improves neurological outcome when applied after cardiac arrest. In a 3-year randomized, prospective, multicenter clinical trial, we hypothesized that mild resuscitative cerebral hypothermia (32 degrees C to 34 degrees C core temperature) would improve neurological outcome after cardiac arrest. METHODS: We lowered patients' temperature after admission to the emergency department and continued cooling for at least 24 hours after arrest in conjunction with advanced cardiac life support. The cooling technique chosen was external head and total body cooling with a cooling device in conjunction with a blanket and a mattress. Infrared tympanic thermometry was monitored before a central pulmonary artery thermistor probe was inserted. RESULTS: In 27 patients (age 58 [interquartile range [IQR] 52 to 64] years; 7 women; estimated "no-flow" duration 6 [IQR 1 to 11] minutes and "low-flow" duration 15 [IQR 9 to 23] minutes; admitted to the emergency department 36 [IQR 24 to 43] minutes after return of spontaneous circulation), we could initiate cooling within 62 (IQR 41 to 75) minutes and achieve a pulmonary artery temperature of 33+/-1 degrees C 287 (IQR 42 to 401) minutes after cardiac arrest. During 24 hours of mild resuscitative hypothermia, no major complications occurred. Passive rewarming >35 degrees C was accomplished within 7 hours. CONCLUSIONS: Mild resuscitative hypothermia in patients is feasible and safe. A clinical multicenter trial might prove that mild hypothermia is a useful method of cerebral resuscitation after global ischemic states.

Brain↗

PubMed2000

Chemiluminescence because of the production of reactive oxygen species in the lungs of newborn piglets during resuscitation periods after asphyxiation load.

Reactive oxygen species are regarded as a possible cause of many diseases. However, there are few reports offering in vivo and in situ proof of the direct involvement of reactive oxygen species in the pathogenesis of disease. In the present study, the luciferin derivative 2-methyl-6-[4-methoxyphenyl]-3,7-dihydroimidazo [1,2-alpha] pyrazin-3-one (MCLA) was used to investigate the amount of reactive oxygen species produced during resuscitation after asphyxiation load in newborn piglets. The animals were first asphyxiated by stopping respiration for 4 min, and then resuscitated using 100% oxygen. When physiologic saline solution was administered, lung surface chemiluminescence had a mean value of 2, whereas with MCLA, a maximum luminescence of 580 was seen, demonstrating the possibility of measuring reactive oxygen species in vivo and in situ using MCLA. In a group in which resuscitation after acute asphyxiation was performed with 21% oxygen, the relative maximum lung surface chemiluminescence was 59.5+/-39, whereas that for a group in which resuscitation was performed using 100% oxygen had a significantly higher value of 186.1+/-72.5. Consequently, ventilation and especially resuscitation by 100% oxygen may represent a potential danger.

Animals↗

PubMed1985

Pyridoxylated polyhemoglobin as a red cell substitute for resuscitation of lethal hemorrhagic shock in conscious rats.

In our previous work, pyridoxylated polyhemoglobin (PP-PolyHB) was shown to have a P50 = 16-18 torr, and a half-life (T 1/2) of 20 hrs in the circulation of rats given a 75% isovolemic exchange transfusion. For the present study, a rapid and lethal hemorrhagic shock model has been specifically designed to assess the ability of PP-PolyHB to function as an emergency resuscitation fluid. Using 48 fully conscious rats with special chronic arterial and venous cannulations, shock was induced by bleeding 67% of total blood volume in less than 40 min; producing 100% mortality in nonresuscitated controls. Resuscitation was carried out using one of the following infusion fluids equivalent in volume to the bled volume: Ringer's solution, albumin solution, stroma-free Hb (SFHb), pyridoxylated SFHb (PP-SFHb), PP-PolyHb, and whole blood. Long-term (greater than 8 day) survival rate of rats (n = 12) resuscitated with PP-PolyHb was 75% compared to 83% for autologous whole blood. Survival following resuscitation with the other fluids was substantially lower. These results indicate that PP-PolyHb could effectively resuscitate lethal hemorrhagic shock in conscious rats, and provide long-term survival afterwards, even in the absence of any additional fluid maintenance.

Animals↗

PubMedDate not supplied

[Endotracheal aspiration: respirator vs. manual resuscitation as method for hyperoxygenation and hyperinflation].

Endotracheal aspiration protocols (EAT) include hyperoxygenation and hyperinflation to minimize the negative effects of the technique. No conclusive studies have determined the most effective hyperoxygenation and hyperinflation method. This study had two aims: to compare the effects on patient oxygenation and hemodynamics during endotracheal aspiration of secretions using, respectively, a respirator or manual resuscitator as the hyperoxygenation and hyperinflation method. Tidal volume (TV) and FIO2 with the manual resuscitator were quantified. The study was based on 172 aspiration sessions carried out under artificial ventilation in the immediate postoperative period of 26 patients who had undergone cardiac surgery without lung damage. Hyperinflation and hyperoxygenation before, during and after aspiration were carried out with and artificial ventilator in group I and with a manual resuscitator in group II. In all aspiration interventions, an analysis was made of hemodynamic parameters (MAP, MPAP, HR, CO and arrhythmias), ventilation and oxygenation parameters (HR, FIO2, SpO2, and SvO2), and the influence of the method on the appearance of atelectasis. Both methods produced small increases in all hemodynamic parameters, and significant differences in HR (p < 0.001) and MPAP (p < 0.002), although no clinical repercussions were observed. No severe arrhythmias were observed. No statistically significant differences between the two methods were found in the evolution of SpO2 and SvO2, which remained above baseline levels throughout both procedures. Analysis of the effectiveness of the manual resuscitator (the second aim) under the conditions established yielded a mean FIO2 of 0.86 and a mean tidal volume of 153% in relation to baseline tidal volume. Both methods of hyperoxygenation and hyperinflation prevent hypoxia and maintain hemodynamic stability in patients without producing lung damage. The effectiveness of the manual resuscitator for administering high oxygen concentration and large volumes was confirmed.

Aged↗

PubMed2001

[A clinical study on the effects of delayed rapid fluid resuscitation on the blood circulation during postburn shock stage].

OBJECTIVE: To explore the protocol for the quick correction of postburn shock in case of delayed resuscitation. METHODS: Twenty burn patients inflicted with 40% or bigger TBSA burn, and who were in shock due to delayed admission to hospital, were enrolled in the study. The patients were treated by delayed rapid fluid resuscitation. The amount of infused fluid and urine output was observed. The indices of hemodynamics and oxygen metabolism, i.e. arterial blood pressure (BP), pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), central venous pressure(CVP), cardiac output (CO), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), oxygen delivery (DO2), oxygen consumption (VO2), oxygen extraction (O2ext), lactic acid (LA) and base deficit (BD) were monitored at the shock stage(1 approximately 48 PBHs). RESULTS: The amount of rapid fluid infusion within 2 hours after admission accounted for (38.8 +/- 6.1)% of the amount calculated with the formula (The Third Military Medical University burn shock fluid infusion formula) for the 1st 24 PBHs. When the amount of prehospital infusion was added, the amount would be (48.3 +/- 5.0)% of the amount for the 1st 24 PBHs. The real amount of the infusion for the 1st 24 PBHs was (31.4 +/- 14.3)% more than that of the formula amount, and the real infused fluid amount for the 2nd 24 PBHs was (3.2 +/- 7.2)% more than that of the formula amount. After rapid fluid infusion, there exhibited remarkable increase in urine output, CO and DO2 with evident decrease in SVR, LA and BD. Furthermore, PAWP, PAP and CVP remained within normal range even though PVR increased significantly after rapid fluid infusion. CONCLUSION: In case of shock or compulsory delayed resuscitation, rapid fluid resuscitation during early postburn stage was beneficial with critical hemodynamic monitoring. The amount of delayed rapid fluid infusion was much increased than routine. Hemodynamic indices such as CO, PAP, PAWP and CVP were employed as the guidelines for delayed rapid resuscitation with reference to some clinical indices such as serum LA, blood gas analysis and urine output.

Adolescent↗

PubMed2001

Resuscitation and evaluation of non-beating hearts obtained from asphyxiated dogs via autoperfusing heart-lung circuit.

BACKGROUND: The shortage of donor hearts has made use of non-beating hearts as cardiac grafts an attractive possibility for heart transplant candidates. The purpose of this study was to evaluate the utility of leukocyte-depleted hot shot cardioplegia for resuscitation of non-beating hearts obtained from asphyxiated dogs via an autoperfusing heart-lung circuit. METHODS: Mongrel dogs were divided into 3 groups according to the warm ischemia time and the method of reperfusion before starting the autoperfusing heart-lung circuit. Group A (n=4) had 60 minutes of warm ischemia and reperfusion without leukocyte-depleted hot shot, Group B (n=5) had 30 minutes of warm ischemia and reperfusion with leukocyte-depleted hot shot, and Group C (n=7) had 60 minutes of warm ischemia and reperfusion with leukocyte-depleted hot shot. We calculated stroke work via the heart-lung circuit to evaluate cardiac function of the resuscitated hearts. The criteria for "recovery" has been reported elsewhere. Myocardial water content of the resuscitated hearts was also measured and analyzed. No inotropic agents were used. RESULTS: The recovery rates in groups A, B and C were 0%, 80% and 57%, respectively, and the group B rate was significantly higher than the group A rate (p=0.04). Although myocardial water content did not differ between groups B and C, it was significantly lower in recovered hearts than in non-recovered hearts (p=0.04). Significant negative correlation was observed between the maximum stroke work value and myocardial water content in the resuscitated hearts (r=0.668, p=0.03). CONCLUSIONS: The autoperfusing heart-lung circuit is useful for evaluation and maintenance of cardiac function. Our experimental data shows that leukocyte-depleted hot shot plays a great role for resuscitation and recovery of non-beating hearts.

Animals↗

PubMed2002

[Guidelines for uniform reporting of data from out-of-hospital and in-hospital cardiac arrest and resuscitation in the pediatric population: the pediatria utstein-style].

Children who require cardiopulmonary resuscitation present high mortality and morbidity. The few studies that have been published on this subject use different terminology and methodology in data collection, which makes comparisons, evaluation of efficacy, and the performance of meta-analyses, etc. difficult. Consequently, standardized data collection both in clinical studies on cardiorespiratory arrest and in cardiopulmonary resuscitation in the pediatric age group are required. The Spanish Group of Pediatric Cardiopulmonary Resuscitation emphasizes that recommendations must be simple and easy to understand. The first step in the elaboration of guidelines on data collection is to develop uniform definitions (glossary of terms). The second step comprises the so-called time intervals that include time periods between two events. To describe the intervals of cardiorespiratory arrest different clocks are used: the patient's watch, that of the ambulance, the interval between call and response, etc.Thirdly, a series of clinical results are gathered to determine whether the efforts of cardiopulmonary resuscitation have a positive effect on the patient, the patient's family and society. With the information gathered a registry of data that includes the patient's personal details, general data of the cardiopulmonary resuscitation, treatment, times of performance and definitive patient outcome is made.

Adolescent↗

PubMed1998

[The study on the culture, freezing preservation and resuscitation of human trabecular cells in vitro].

PURPOSE: To establish the culture of human trabecular cells in vitro and study the freezing preservation and resuscitation. METHODS: The trabecular specimens from human eyes were cultured in vitro and passaged 3 times, then the cultured cells were frozen and preserved. The frozen cells were resuscitated after one week, two weeks, one month and two months. RESULTS: Cultured human trabecular cells were obtained. The frozen cells were resuscitated successfully. All of the resuscitated rates were more than 90%. CONCLUSION: The human trabecular cells were cultured in vitro successfully, they can also be frozen and resuscitated, which will be helpful to the establishment of cDNA library and the screening of associated glaucomatous genes.

Cell Division↗

PubMed2004

[An early comprehensive prevention and treatment of sepsis in severely burned patients with delayed fluid resuscitation].

OBJECTIVE: To study an early comprehensive prevention and treatment of sepsis in severely burned patients with delayed fluid resuscitation. METHODS: From January 1990 to December 2001, 72 cases of patients with delayed fluid resuscitation were admitted to our burn department. Two different periods were divided and analyzed retrospectively. The first period was from January 1990 to December 2001 and the span of the second period was from January 1995 to December 2001. RESULTS: (1)The mortality rate and incidence of sepsis in the second period (6.5 percent and 17.4 percent) were significantly lower than those of the first period (23.0 percent and 57.7 percent, P<0.05 and P<0.01). (2)The time of wound healing in the second period was (1.9+/-0.9) hours, it was lower than that of the first period (6.6+/-2.5) hours. (3)The serum contents of tumor necrosis factor (TNF) and blood lactic acid (BLA) were increased at all times in two periods and were markedly increased in the first period (all P<0.01). CONCLUSION: Our data demonstrated that measures adopted in the second period for patients with delayed fluid resuscitation, including early excision, early rapid adequate resuscitation, early enteral feeding, increased immunity function, early applying antibactials, xenotransfusion of ultraviolet-irradiated blood, application of recombinant human-growth factor (rh-GH), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), are beneficial to the prevention and treatment of sepsis in severely burned patients with delayed fluid resuscitation.

Adult↗

PubMed1991

Cardiac contractility and blood flow distribution following resuscitation with 7.5% hypertonic saline in anesthetized dogs.

We examined the specific effects of 7.5% hypertonic saline (HTS) on myocardial performance and regional blood flow and compared the efficacies of HTS and lactated Ringer's solution (LR) for hypovolemic resuscitation. Studies were performed in anesthetized dogs subjected to rapid hemorrhage to decrease mean arterial pressure by 50% over 60 min. The animals were resuscitated with either HTS (n = 8) at 5 ml/kg or LR (n = 7) at a dose required for equivalent restoration of cardiac output. Cardiac contractility was assessed using the slope Ees of the left ventricular end-systolic pressure-diameter relationship and regional blood flow was measured using radioactive microspheres. At 10 min after resuscitation, mean arterial pressure increased from 45.1 +/- 2.5 to 77.7 +/- 3.2 mmHg with HTS and 50.9 +/- 2.5 to 80.1 +/- 3.2 mmHg with LR. Resuscitation with either fluid caused significant increases in heart rate and similar decreases in vascular resistance. Cardiac contractility (Ees) did not change significantly with LR, whereas with HTS, Ees increased from 14.8 +/- 0.9 during hemorrhage to 19.4 +/- 1.6 as compared with a baseline value of 13.4 +/- 1.5 mmHg/mm. Hemorrhage decreased blood flow to various organs by 50% to 70% of baseline. Except for better improvement in splenic and hepatic perfusion with HTS, similar restoration of blood flow to the heart, muscle, skin, kidney, and jejunum was observed at 10 min after resuscitation with either fluid. In this animal model of rapid and severe hemorrhagic shock, HTS given at approximately one-sixth the volume of LR was equally effective in providing temporary restoration of hemodynamic function.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1989

Cerebral blood flow following hypertonic saline resuscitation in an experimental model of hemorrhagic shock and head injury.

Hypertonic (3.0%) saline (HS) resuscitation from hemorrhagic shock is associated with less cerebral edema and lower intracranial pressure (ICP) compared to normal saline (NS) and 10% Dextran 40 (D-40). The effect of HS resuscitation on cerebral blood flow (CBF) is unknown. Beagle dogs with a head injury underwent shock and resuscitation, receiving either NS (N = 6), HS (N = 6), or D-40 (N = 6). CBF (via a microsphere technique) and ICP were measured at baseline (BL) and at end shock (ES) after infusion of shed blood and test fluid (ER) and 2 hours after resuscitation (LR). CBF was determined globally (GCBF), and for the right (RCBF) and left (LCBF) cerebral hemispheres. ICP values (+/- SEM) at BL and ES were 10.8 +/- 1.31 mmHg and 8.0 +/- 1.67 mmHg, respectively, for all groups. GCBF, RCBF and LCBF at BL were 29.4 +/- 5.04, 26.7 +/- 4.93 and 26.6 +/- 4.50 ml 100 g-1 min-1, respectively. ES values for CBF were not significantly different from BL. Global and hemispheric CBF values were not different between groups at times measured. ICP was significantly lower in animals receiving HS. Therefore, lower ICP following HS resuscitation is not associated with alteration in CBF.

Animals↗

PubMed1995

Effect of resuscitation solutions on the immune status of dogs in hemorrhagic shock.

The purpose of this study is to examine the effects of three different types of fluid resuscitation on the immune system of dogs in hemorrhagic shock. Using a modified Wigger shock model, 18 conditioned male dogs were bled to mean arterial blood pressure of 60 mm Hg for 90 minutes and placed into three groups based on the resuscitative method. Group I: Crystalloid Resuscitation; Group II: Autotransfusion; Group III: Banked Blood. Laboratory methods for immune status evaluation included total lymphocyte count, T4/T8 ratio, total serum immunoglobulins, and immunoglobulin electrophoresis. These values were obtained pre-hemorrhagic shock, just before resuscitation, and subsequently on days 1, 4, and 7. Humoral immunity, represented by total serum immunoglobulin levels (IgA, IgG, IgM), was higher in Groups II and III when compared with group I on all post-resuscitation days. IgA and IgM levels were higher in Group III compared with Groups I and II. IgG level was higher in Group II compared with Groups I and III. Cellular immunity was also affected by transfusion. Total lymphocyte count was increased in Group II on Day 1; however, the three groups were similar with respect to this variable on subsequent days. The absolute T4 helper cell level in Group II was similar to Groups I and III until Day 7, at which time the level became higher in Group II.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

[Delayed fluid resuscitation induced bacterial translocation after lethal thermal injury: role of oxygen free radical injury of intestinal mucosa].

The Present investigation was undertaken to examine the effect of delayed fluid resuscitation (DFR), after lethal thermal injury on oxygen free radical (OFR) injury of intestinal mucosa and its relationship to bacterial translocation. Four groups of gnotobiotic rats with 5 strains of bacteria were studied: sham injury group (control) (n = 6): early fluid resuscitation (EFR) group (n = 24) receiving resuscitation (Parkland) immediately after scald (40% TBSA, third degree); DFR group (n = 24) receiving resuscitation 6 hours after scald; treatment group (n = 12), rats with DFR receiving VitE and VitC treatment before resuscitation 12, 24, 48 and 72 hours after injury, animals (n = 6, at each point) were sacrificed. Plasma endotoxin level, mucosal SOD, GSHPx, MDA and diamine oxidase (DAO) of ileum were determined, and cultures of the mesenteric lymph nodes (MLN), liver, spleen, heart, lung, kidney and blood were done. The level of mucosal MDA and plasma endotoxin and the incidence of bacteria translocation (IBT) to tissues were significantly higher and mucosal SOD, GSHPx, DAO activity significantly lower in DFR group as compared with that in EFR group at most of the time points. In DFR group, mucosal MDA content was negatively correlated with mucosal DAO activity, which correlated positively with plasma endotoxin level and IBT. After treatment with VitE and VitC, mucosal MDA content was decreased, plasma endotoxin level and IBT were significantly decreased, and mucosal DAO activity was significantly increased. Our data indicated that DFR in cases of burn shock can result in OFR injury of intestinal mucosa, disrupting mucosal barrier and promoting translocation of intestinal bacteria and endotoxin.

Amine Oxidase (Copper-Containing)↗