Administration of recombinant interleukin-11 improves the hemodynamic functions and decreases third space fluid loss in a porcine model of hemorrhagic shock and resuscitation

• Published in: Shock (Augusta, Ga.) Ga.), 2005-06, Vol.23 (6), p.539-542
• Main Authors: HONMA, Kaneatsu, KOLES, Nancy L, ALAM, Hasan B, RHEE, Peter, ROLLWAGEN, Florence M, OLSEN, Cara, KEITH, James C, POLLACK, Matthew
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Blood Pressure; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Carbon Monoxide; Cardiac Output - drug effects; Disease Models, Animal; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Hemodynamics; Intensive care medicine; Interleukin-11 - administration & dosage; Interleukin-11 - metabolism; Lactates - metabolism; Medical sciences; Pressure; Random Allocation; Recombinant Proteins - administration & dosage; Resuscitation; Shock, Hemorrhagic - drug therapy; Shock, Hemorrhagic - veterinary; Sodium Chloride - pharmacology; Swine; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 1073-2322; 1540-0514
• DOI: 10.1097/01.shk.0000162235.37135.dc

We have previously demonstrated that the administration of recombinant human interleukin-11 (rhIL-11) during resuscitation improves the blood pressure in a rodent model of hemorrhagic shock. The purpose of this study was to determine whether the effects of rhIL-11 could be reproduced in a large animal model and to elucidate the impact of rhIL-11 administration on the intravascular volume status and the degree of third space fluid loss after resuscitation. A 40% blood volume hemorrhage was induced in swine (n = 45, weight of 25-35 kg) followed by a 1-h shock period and resuscitation with 0.9% sodium chloride (three times the shed blood volume). The animals were randomized to receive sham hemorrhage (group I, sham); sham hemorrhage and 50 microg/kg rhIL-11 (group II, sham + IL-11); no drug (group III, saline); or 50 microg/kg rhIL-11 (group IV, IL-11). Blood and urine samples were obtained and analyzed at baseline, at the end of hemorrhaging, and thereafter once every hour. The pleural and peritoneal effusions were precisely quantified by using clinically accepted criteria. The mean arterial pressure (MAP) was higher postresuscitation (PR) in groups I, II, and IV (71.4 +/- 7.5 mmHg, 71.0 +/- 8.9 mmHg, and 72.9 +/- 12.3 mmHg, respectively) than in group III (59.9 +/- 10.9 mmHg), and the cardiac output of PR was higher in group IV (3.46 +/- 0.56 L/min) than in group III (2.99 +/- 0.62 L/min; P < 0.01). The difference in MAP between groups I and II became statistically significant at 40 min after rhIL-11 injection and such a difference persisted for 90 min. After resuscitation, the urine output was higher, and the urine specific gravity and third space fluid loss were lower in group IV (1434 +/- 325 mL and 1.0035, 82 +/- 21 mL) than in group III (958 +/- 390 mL and 1.0053, 125 +/- 32 mL; P < 0.05). In a porcine model of hemorrhagic shock, the administration of rhIL-11 at the start of resuscitation significantly improved the cardiac output and blood pressure. This strategy also significantly reduced the extent of third space fluid losses while also having a favorable impact on the intravascular volume status as evidenced by the improved urine output.