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Effects of crystalloid and colloid resuscitation on hemorrhage-induced vascular hyporesponsiveness to norepinephrine in the rat.
J Trauma. 2003 May; 54(5 Suppl):S159-68.JT

Abstract

BACKGROUND

We have shown previously that hemorrhagic hypotension is associated with a progressive development of vascular hyporeactivity to norepinephrine (NE). The present study investigated whether select crystalloid or colloid resuscitation fluids would ameliorate this effect.

METHOD

Anesthetized male rats were hemorrhaged to and maintained at a mean arterial pressure (MAP) of 50 mm Hg for 60 minutes. Rats (n = 7 per group) were then resuscitated with lactated Ringer's (LR), 7.5% hypertonic saline (HS) for 1 hour followed by LR (HS-LR), Hespan, or Hextend to restore and maintain MAP to 70 mm Hg over 4 hours. Additional hemorrhaged groups were resuscitated with LR to the baseline MAP (LR-BL) or received no resuscitation. A sham hemorrhage group served as controls. The responses of MAP and the blood flow of the superior mesenteric, celiac, left renal, and left femoral arteries to NE (3 microg/kg administered intravenously) were measured at BL (prehemorrhage); at the end of the hypotensive period; and at 1, 2, and 4 hours after resuscitation.

RESULTS

Hemorrhagic hypotension significantly (p < 0.01) reduced the NE-induced pressor response in MAP and significantly reduced the contractile responses (reflected by the reduction of blood flow after NE administration) of the four arteries to NE. Hespan and Hextend infusion improved the NE response of MAP and the contractile responses of the observed arteries to NE significantly better than LR, HS-LR, or LR-BL. The colloids improved the vascular contractile responses to NE in the superior mesenteric and left femoral arteries and the pressor response of MAP to NE, to 80% to 90% of their basal response level compared with 40% to 60% with the crystalloid fluids (p < 0.05). LR-BL infusion resulted in hemodilution, with no added benefit to vascular responsiveness.

CONCLUSION

These data suggest that hypotensive resuscitation to 70 mm Hg with colloids was better than crystalloids in improving vascular responsiveness to the pressor effects of NE and required smaller volumes. Normotensive resuscitation with LR was not better than hypotensive resuscitation. Not all vasculatures improved equally after fluid resuscitation.

Authors+Show Affiliations

U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-6315, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

12768120

Citation

Liu, Liang-Ming, et al. "Effects of Crystalloid and Colloid Resuscitation On Hemorrhage-induced Vascular Hyporesponsiveness to Norepinephrine in the Rat." The Journal of Trauma, vol. 54, no. 5 Suppl, 2003, pp. S159-68.
Liu LM, Ward JA, Dubick MA. Effects of crystalloid and colloid resuscitation on hemorrhage-induced vascular hyporesponsiveness to norepinephrine in the rat. J Trauma. 2003;54(5 Suppl):S159-68.
Liu, L. M., Ward, J. A., & Dubick, M. A. (2003). Effects of crystalloid and colloid resuscitation on hemorrhage-induced vascular hyporesponsiveness to norepinephrine in the rat. The Journal of Trauma, 54(5 Suppl), S159-68.
Liu LM, Ward JA, Dubick MA. Effects of Crystalloid and Colloid Resuscitation On Hemorrhage-induced Vascular Hyporesponsiveness to Norepinephrine in the Rat. J Trauma. 2003;54(5 Suppl):S159-68. PubMed PMID: 12768120.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of crystalloid and colloid resuscitation on hemorrhage-induced vascular hyporesponsiveness to norepinephrine in the rat. AU - Liu,Liang-Ming, AU - Ward,John A, AU - Dubick,Michael A, PY - 2003/5/28/pubmed PY - 2003/6/25/medline PY - 2003/5/28/entrez SP - S159 EP - 68 JF - The Journal of trauma JO - J Trauma VL - 54 IS - 5 Suppl N2 - BACKGROUND: We have shown previously that hemorrhagic hypotension is associated with a progressive development of vascular hyporeactivity to norepinephrine (NE). The present study investigated whether select crystalloid or colloid resuscitation fluids would ameliorate this effect. METHOD: Anesthetized male rats were hemorrhaged to and maintained at a mean arterial pressure (MAP) of 50 mm Hg for 60 minutes. Rats (n = 7 per group) were then resuscitated with lactated Ringer's (LR), 7.5% hypertonic saline (HS) for 1 hour followed by LR (HS-LR), Hespan, or Hextend to restore and maintain MAP to 70 mm Hg over 4 hours. Additional hemorrhaged groups were resuscitated with LR to the baseline MAP (LR-BL) or received no resuscitation. A sham hemorrhage group served as controls. The responses of MAP and the blood flow of the superior mesenteric, celiac, left renal, and left femoral arteries to NE (3 microg/kg administered intravenously) were measured at BL (prehemorrhage); at the end of the hypotensive period; and at 1, 2, and 4 hours after resuscitation. RESULTS: Hemorrhagic hypotension significantly (p < 0.01) reduced the NE-induced pressor response in MAP and significantly reduced the contractile responses (reflected by the reduction of blood flow after NE administration) of the four arteries to NE. Hespan and Hextend infusion improved the NE response of MAP and the contractile responses of the observed arteries to NE significantly better than LR, HS-LR, or LR-BL. The colloids improved the vascular contractile responses to NE in the superior mesenteric and left femoral arteries and the pressor response of MAP to NE, to 80% to 90% of their basal response level compared with 40% to 60% with the crystalloid fluids (p < 0.05). LR-BL infusion resulted in hemodilution, with no added benefit to vascular responsiveness. CONCLUSION: These data suggest that hypotensive resuscitation to 70 mm Hg with colloids was better than crystalloids in improving vascular responsiveness to the pressor effects of NE and required smaller volumes. Normotensive resuscitation with LR was not better than hypotensive resuscitation. Not all vasculatures improved equally after fluid resuscitation. SN - 0022-5282 UR - https://www.unboundmedicine.com/medline/citation/12768120/Effects_of_crystalloid_and_colloid_resuscitation_on_hemorrhage_induced_vascular_hyporesponsiveness_to_norepinephrine_in_the_rat_ L2 - https://doi.org/10.1097/01.TA.0000054649.46525.A5 DB - PRIME DP - Unbound Medicine ER -