Hypertonic saline dextran attenuates leukocyte accumulation in the liver after hemorrhagic shock and resuscitation

J Trauma. 1999 Mar;46(3):417-23. doi: 10.1097/00005373-199903000-00011.

Abstract

Background: Hemorrhagic shock and resuscitation triggers a global ischemia/reperfusion phenomenon, in which activated leukocytes are considered strong contributors to the ensuing tissue damage.

Methods: The aim of the study was to investigate the effects of hypertonic saline dextran (HSD) on the early leukocyte/endothelial interactions (intravital fluorescence microscopy) in a rat model of hemorrhagic shock (1 hour at mean arterial pressure of 40 mm Hg). The resuscitation was performed with lactated Ringer's solution (RL, four times shed blood/20 minutes, n = 6), 6% dextran 60 (DEX, 100% shed blood/5 minutes, n = 8), and 7.2% NaCl/10% dextran 60 (HSD, 10% shed blood/2 minutes, n = 8).

Results: After 1 hour of resuscitation, shock-induced stasis/adherence of leukocytes was further enhanced with RL (sinusoids 17.6+/-6.9%; venules 33.9+/-8.5%), whereas DEX and HSD attenuated leukocyte stagnation in sinusoids (DEX -7.4+/-6,1%; HSD -14.7+/-2.9%, p<0.01 vs. RL) and leukocyte adherence in postsinusoidal venules (DEX -12.2+/-8.6%, p<0.05 vs. RL; HSD -27+/-7.4%, p<0.01 vs. RL).

Conclusion: HSD reduced significantly the number of leukocytes accumulated in the liver after resuscitation of hemorrhagic shock, probably due to a combination of mechanisms of both components.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Dextrans / therapeutic use*
  • Disease Models, Animal
  • Drug Evaluation, Preclinical
  • Endothelium / immunology
  • Humans
  • Isotonic Solutions / therapeutic use
  • Laser-Doppler Flowmetry
  • Leukocytes / drug effects*
  • Leukocytes / immunology*
  • Liver / immunology*
  • Male
  • Microscopy, Fluorescence
  • Rats
  • Rats, Wistar
  • Reperfusion Injury / etiology
  • Reperfusion Injury / immunology*
  • Reperfusion Injury / therapy*
  • Resuscitation / adverse effects*
  • Resuscitation / methods*
  • Ringer's Lactate
  • Shock, Hemorrhagic / complications*
  • Shock, Hemorrhagic / therapy
  • Sodium Chloride / therapeutic use*
  • Time Factors

Substances

  • Dextrans
  • Isotonic Solutions
  • Ringer's Lactate
  • hypertonic saline-dextran solution
  • Sodium Chloride