Immune response in fluid therapy with crystalloids of different ratios or colloid for rats in haemorrhagic shock

Abstract

This study investigated the association between different ratios of balanced salt based-crystalloid (PLASMA SOLUTION-A [CJ HealthCare, Seoul, Korea]) (the ratios of crystalloid for blood loss, 1:1, 1:2 and 1:3) or balanced salt-based colloid (VOLULYTE 6% [Fresenius Kabi, Germany]) (the ratio of colloid for blood loss, 1:1) to restore blood loss and immune response in rats with haemorrhagic shock. About 50% of total estimated blood volume was removed after anaesthesia. The fluid was administered for resuscitation after exsanguination, according to the type of fluid and the ratios of exsanguinated volume and fluid volume for resuscitation. After sacrifice, expression of immune cells in blood and tissues was evaluated. Histological analyses and syndecan-1 immunohistochemistry assays were performed on tissues. Endothelial damage according to syndecan-1 and cytokine levels in blood was also assessed. Fluid resuscitation with same, twofold , or threefold volumes of crystalloid, or same volume of colloid, to treat haemorrhagic shock in rats resulted in a similar increase in blood pressure. The expression of neutrophils in blood decreased significantly after colloid administration, compared to before exsanguination. Syndecan-1 expression increased after exsanguination and fluid resuscitation in all groups, without any significant difference. In conclusion, same volume of balanced salt-based crystalloid for blood loss was enough to restore BP at the choice of fluid for the management of haemorrhagic shock in the rats, compared with different ratios of crystalloid or same volume of colloid, on the aspect of immune response.

Effects of Different Types of Early Restrictive Fluid Resuscitation on Immune Function and Multiorgan Damage on Hemorrhagic Shock Rat Model in a Hypothermic Environment

“…The abnormal inflammatory state causes the body immune system to damage endothelial tissues and ultimately organs, in addition to the postischaemic reperfusion injury of shock, which further activates neutrophils and mediates the release of cytokines and free radicals probably leading to secondary damage. The early and rapid fluid resuscitation was reported to lead to immune damage and exacerbates the inflammatory response [ 20 ]. In this study, we showed that the inflammatory response is activated in the early phase of hemorrhagic shock in a hypothermic environment, and the inflammatory factors including TNF- α , IL-6, IL-8, and IL-10 are significantly increased, and the plasma proinflammatory factors such as TNF- α , IL-6, and IL-8 are increased, while the levels of anti-inflammatory factor IL-10 are decreased in rats given unrestricted fluid resuscitation.…”

Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model

“…In our study, as a requirement of goal-directed therapy, 3 times more crystalloid volume was applied compared to the colloid resuscitation. This 3-fold difference was due to the unbalance character of the fluids used in the present study [26], and despite this 3-fold difference, equal hematocrit levels were found in both resuscitation strategies. This result was previously described as general characteristics of crystalloid-based solutions due to rapidly shifting to the extravascular area [4].…”