Improving microcirculation is more effective than substitution of red blood cells to correct metabolic disorder in experimental hemorrhagic shock

Microcirculatory perfusion deficits and impaired tissue oxygenation in nonvital organs frequently occur after hemorrhage and they contribute to potentially lethal complications. The aim of this study was to test the influence of colloid osmotic pressure, viscosity, and red blood cell (RBC) content o...

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Bibliographic Details
Published in:Shock (Augusta, Ga.) Ga.), 2004-03, Vol.21 (3), p.235-240
Main Authors: WETTSTEIN, Reto, TSAI, Amy G, ERNI, Dominique, LUKYANOV, Anatoly N, TORCHILIN, Vladimir P, INTAGLIETTA, Marcos
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Arteries - pathology
Biological and medical sciences
Capillaries - metabolism
Carotid Arteries - pathology
Colloids - metabolism
Cricetinae
Erythrocytes - metabolism
Hemoglobins - chemistry
Hemoglobins - metabolism
Hydrogen-Ion Concentration
Intensive care medicine
Medical sciences
Microcirculation
Osmosis
Osmotic Pressure
Oxygen - metabolism
Oxygen Consumption
Partial Pressure
Perfusion
Polyethylene Glycols - chemistry
Pressure
Serum Albumin, Bovine - metabolism
Shock, Hemorrhagic - pathology
Time Factors
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Summary:Microcirculatory perfusion deficits and impaired tissue oxygenation in nonvital organs frequently occur after hemorrhage and they contribute to potentially lethal complications. The aim of this study was to test the influence of colloid osmotic pressure, viscosity, and red blood cell (RBC) content of the resuscitative fluid on metabolic disorder, perfusion, and oxygenation in peripheral tissues. Awake hamsters were subjected to hemorrhage of 50% and were resuscitated with 25% of blood volume with solutions containing 6% pegylated bovine albumin only (PEG-BSA 0) and 6% PEG-BSA mixed with autologous RBCs to reach 4 g/dL (PEG-BSA 4) and 8 g/dL (PEG-BSA 8) of hemoglobin. PEG-BSA had a viscosity of 4.2 cP and a COP of 116 mmHg. Microhemodynamics and tissue pO2 were assessed in the hamster chamber window preparation with intravital microscopy. Arterial base excess tended to be lower than baseline for PEG-BSA 0 and PEG-BSA 4 (ns), whereas base deficit remained significantly decreased for PEG-BSA 8 (P
ISSN:1073-2322
1540-0514
DOI:10.1097/01.shk.0000114301.36496.ea