Adenosine, lidocaine and Mg2+ (ALM) induces a reversible hypotensive state, reduces lung edema and prevents coagulopathy in the rat model of polymicrobial sepsis

Abstract

An ALM bolus/infusion induces a stable, hypotensive hemodynamic state with no arrhythmias, significantly less pulmonary edema, and a higher BT and prevents coagulopathy compared with the controls.

Correction of acute traumatic coagulopathy with small-volume 7.5% NaCl adenosine, lidocaine, and Mg2+ occurs within 5 minutes

“…16,17 In 2012, we further reported that 7.5% NaCl with ALM led to a full correction of platelet-poor plasma prothrombin time (PT) and activated partial thromboplastin time (aPTT) at 60-minute resuscitation. 20,21 Given the clinical significance of early detection and treatment of coagulopathy, the aim of the present study was to expand on our previous work and investigate the timing of 7.5% NaCl with ALM correction using ROTEM in the rat model of severe hemorrhagic shock compared with 7.5% NaCl controls. 20,21 Given the clinical significance of early detection and treatment of coagulopathy, the aim of the present study was to expand on our previous work and investigate the timing of 7.5% NaCl with ALM correction using ROTEM in the rat model of severe hemorrhagic shock compared with 7.5% NaCl controls.…”

Small-Volume Adenosine, Lidocaine, and Mg 2+ 4-Hour Infusion Leads to 88% Survival after 6 Days of Experimental Sepsis in the Rat without Antibiotics

“…At present, we do not know the relative contributions of adenosine, lidocaine, or magnesium to ALM protection in our rat model of polymicrobial sepsis (9,16). Individually, adenosine and lidocaine have a long history in sepsis research, but neither have realized therapeutic potential in the clinical setting, and hypomagnesemia is a frequent complication of septic and critically ill patients but magnesium therapy for improving outcomes is controversial (44).…”

“…Dual-access vascular ports were fitted within a customized jacket. In CLP rats, a 3-cm midline lapa-rotomy was performed and the cecum was ligated at half the distance between the distal pole and the ileocecal valve (9,18). The ligated portion was punctured once through-and-through with a 21-gauge needle, and a small droplet of stool was milked through each puncture.…”

“…Lung neutrophil infiltration and pro-oxidant activity were estimated from myeloperoxidase (MPO) activity (21), and and malondialdehyde ELISA kits were used to quantify lipid peroxidation (Sigma-Aldrich, Australia). Lung water content was calculated as a percentage based on the formula [(wet weight Ϫ dry weight)/wet weight] ϫ 100 (9).…”

“…Previously, we have shown in the rat model of polymicrobial sepsis, induced by cecal ligation and puncture (CLP), that smallvolume adenosine, lidocaine, and Mg 2ϩ (ALM) induced a stable, hypotensive state over 5 h with no arrhythmias, significantly less pulmonary edema, and corrected coagulopathy (9). The ALM concept has also translated to the pig model of lipopolysaccharide endotoxemia (10).…”