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Resuscitation with lactated ringer's does not increase inflammatory response in a Swine model of uncontrolled hemorrhagic shock.
Shock. 2004 Sep; 22(3):283-7.S

Abstract

Lactated Ringer's (LR) and normal saline (NS) are widely and interchangeably used for resuscitation of trauma victims. Studies show LR to be superior to NS in the physiologic response to resuscitation. Recent in vitro studies demonstrate equivalent effects of LR and NS on leukocytes. We aimed to determine whether LR resuscitation would produce an equivalent inflammatory response compared with normal saline (NS) resuscitation in a clinically relevant swine model of uncontrolled hemorrhagic shock. Thirty-two swine were randomized. Control animals (n = 6) were sacrificed following induction of anesthesia for baseline data. Sham animals (n = 6) underwent laparotomy and 2 h of anesthesia. Uncontrolled hemorrhagic shock animals (n = 10/group) underwent laparotomy, grade V liver injury, and blinded resuscitation with LR or NS to maintain baseline blood pressure for 1.5 h before sacrifice. Lung was harvested, and tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-alpha) were determined using quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). Sections of lung were processed and examined for neutrophils sequestered within the alveolar walls. Cytokine analysis showed no difference in IL-6 gene transcription in any group (P = 0.99). Resuscitated swine had elevated G-CSF and TNF-alpha gene transcription, but LR and NS groups were not different from each other (P= 0.96 and 0.10, respectively). Both resuscitation groups had significantly more alveolar neutrophils present than controls (P < 0.01) and shams (P < 0.05) but were not different from one another (P= 0.83). LR and NS resuscitation have equivalent effects on indices of inflammation in the lungs in our model of uncontrolled hemorrhagic shock.

Authors+Show Affiliations

Department of Surgery, Oregon Health and Science University, Portland, Oregon 97239, USA. wattersj@ohsu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15316400

Citation

Watters, Jennifer M., et al. "Resuscitation With Lactated Ringer's Does Not Increase Inflammatory Response in a Swine Model of Uncontrolled Hemorrhagic Shock." Shock (Augusta, Ga.), vol. 22, no. 3, 2004, pp. 283-7.
Watters JM, Brundage SI, Todd SR, et al. Resuscitation with lactated ringer's does not increase inflammatory response in a Swine model of uncontrolled hemorrhagic shock. Shock. 2004;22(3):283-7.
Watters, J. M., Brundage, S. I., Todd, S. R., Zautke, N. A., Stefater, J. A., Lam, J. C., Muller, P. J., Malinoski, D., & Schreiber, M. A. (2004). Resuscitation with lactated ringer's does not increase inflammatory response in a Swine model of uncontrolled hemorrhagic shock. Shock (Augusta, Ga.), 22(3), 283-7.
Watters JM, et al. Resuscitation With Lactated Ringer's Does Not Increase Inflammatory Response in a Swine Model of Uncontrolled Hemorrhagic Shock. Shock. 2004;22(3):283-7. PubMed PMID: 15316400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resuscitation with lactated ringer's does not increase inflammatory response in a Swine model of uncontrolled hemorrhagic shock. AU - Watters,Jennifer M, AU - Brundage,Susan I, AU - Todd,S Rob, AU - Zautke,Nathan A, AU - Stefater,J A, AU - Lam,J C, AU - Muller,Patrick J, AU - Malinoski,Darren, AU - Schreiber,Martin A, PY - 2004/8/19/pubmed PY - 2005/3/8/medline PY - 2004/8/19/entrez SP - 283 EP - 7 JF - Shock (Augusta, Ga.) JO - Shock VL - 22 IS - 3 N2 - Lactated Ringer's (LR) and normal saline (NS) are widely and interchangeably used for resuscitation of trauma victims. Studies show LR to be superior to NS in the physiologic response to resuscitation. Recent in vitro studies demonstrate equivalent effects of LR and NS on leukocytes. We aimed to determine whether LR resuscitation would produce an equivalent inflammatory response compared with normal saline (NS) resuscitation in a clinically relevant swine model of uncontrolled hemorrhagic shock. Thirty-two swine were randomized. Control animals (n = 6) were sacrificed following induction of anesthesia for baseline data. Sham animals (n = 6) underwent laparotomy and 2 h of anesthesia. Uncontrolled hemorrhagic shock animals (n = 10/group) underwent laparotomy, grade V liver injury, and blinded resuscitation with LR or NS to maintain baseline blood pressure for 1.5 h before sacrifice. Lung was harvested, and tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-alpha) were determined using quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). Sections of lung were processed and examined for neutrophils sequestered within the alveolar walls. Cytokine analysis showed no difference in IL-6 gene transcription in any group (P = 0.99). Resuscitated swine had elevated G-CSF and TNF-alpha gene transcription, but LR and NS groups were not different from each other (P= 0.96 and 0.10, respectively). Both resuscitation groups had significantly more alveolar neutrophils present than controls (P < 0.01) and shams (P < 0.05) but were not different from one another (P= 0.83). LR and NS resuscitation have equivalent effects on indices of inflammation in the lungs in our model of uncontrolled hemorrhagic shock. SN - 1073-2322 UR - https://www.unboundmedicine.com/medline/citation/15316400/Resuscitation_with_lactated_ringer's_does_not_increase_inflammatory_response_in_a_Swine_model_of_uncontrolled_hemorrhagic_shock_ DB - PRIME DP - Unbound Medicine ER -