Comparative effects of crystalloid and small volume hypertonic hyperoncotic fluid resuscitation on hepatic microcirculation after hemorrhagic shock

Circ Shock. 1993 Jul;40(3):187-93.

Abstract

Hepatic microcirculation, leukocyte-endothelial interaction, and sinusoidal widths were studied by means of intravital microscopy in a non-heparinized fixed pressure hemorrhagic shock model in the rat. Asanguineous resuscitation was performed either with "adequate" amounts of lactated Ringer's solution (threefold shed volume/30 min) or 4 ml/kg/3 min 7.2% saline/10% Dextran 60 (HSDex) or 4 ml/kg/3 min 7.2% saline/10% hydroxyethylstarch 200/0.62 (HSHes). Hemorrhagic shock and resuscitation was paralleled by significant (P < 0.01) lumenal narrowing of sinusoids that remained largely uninfluenced by the type of fluid used for resuscitation (HSDex: 9.28 +/- 0.56; HSHes: 8.93 +/- 0.29, LR: 8.87 +/- 0.6 microns compared to 12.17 +/- 0.24 microns in controls). Whereas HSHes and LR-therapy resulted in comparably increased leukocyte adhesion to the sinusoidal wall, the dextran-containing solution led to a significant attenuation of leukocyte-endothelial interaction, suggesting involvement of dextran-binding adhesion molecules, e.g., selectins.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Cell Adhesion
  • Dextrans / administration & dosage
  • Dextrans / therapeutic use
  • Endothelium, Vascular / cytology
  • Female
  • Fluid Therapy*
  • Hydroxyethyl Starch Derivatives / administration & dosage
  • Hydroxyethyl Starch Derivatives / therapeutic use
  • Hypertonic Solutions
  • Isotonic Solutions / administration & dosage
  • Isotonic Solutions / therapeutic use
  • Leukocytes / physiology
  • Liver / blood supply*
  • Microcirculation / physiopathology*
  • Rats
  • Rats, Sprague-Dawley
  • Ringer's Lactate
  • Shock, Hemorrhagic / physiopathology
  • Shock, Hemorrhagic / therapy*

Substances

  • Dextrans
  • Hydroxyethyl Starch Derivatives
  • Hypertonic Solutions
  • Isotonic Solutions
  • Ringer's Lactate