Superiority of acetate compared with lactate in a rodent model of severe hemorrhagic shock

Rohrig, Ricarda; Wegewitz, Christoph; Lendemans, Sven; Petrat, Frank; Groot, Herbert de

doi:10.1016/j.jss.2013.09.005

Cited by 22 publications

(29 citation statements)

References 23 publications

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“…Interestingly, only two of those, acetate and glutamine, also had significant changes due to HS that differed between the rats and AGS. Acetate [33], [34] and glutamate [35], [36] have been shown to have beneficial effects in rat models of HS. Naïve rats had higher concentrations than AGS in both acetate and glutamate but still had I/R damage after HS.…”

Section: Discussionmentioning

confidence: 99%

1H–NMR Metabolomic Biomarkers of Poor Outcome after Hemorrhagic Shock are Absent in Hibernators

et al. 2014

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BackgroundHemorrhagic shock (HS) following trauma is a leading cause of death among persons under the age of 40. During HS the body undergoes systemic warm ischemia followed by reperfusion during medical intervention. Ischemia/reperfusion (I/R) results in a disruption of cellular metabolic processes that ultimately lead to tissue and organ dysfunction or failure. Resistance to I/R injury is a characteristic of hibernating mammals. The present study sought to identify circulating metabolites in the rat as biomarkers for metabolic alterations associated with poor outcome after HS. Arctic ground squirrels (AGS), a hibernating species that resists I/R injury independent of decreased body temperature (warm I/R), was used as a negative control.Methodology/principal findingsMale Sprague-Dawley rats and AGS were subject to HS by withdrawing blood to a mean arterial pressure (MAP) of 35 mmHg and maintaining the low MAP for 20 min before reperfusing with Ringers. The animals’ temperature was maintained at 37±0.5°C for the duration of the experiment. Plasma samples were taken immediately before hemorrhage and three hours after reperfusion. Hydrophilic and lipid metabolites from plasma were then analyzed via 1H–NMR from unprocessed plasma and lipid extracts, respectively. Rats, susceptible to I/R injury, had a qualitative shift in their hydrophilic metabolic fingerprint including differential activation of glucose and anaerobic metabolism and had alterations in several metabolites during I/R indicative of metabolic adjustments and organ damage. In contrast, I/R injury resistant AGS, regardless of season or body temperature, maintained a stable metabolic homeostasis revealed by a qualitative 1H–NMR metabolic profile with few changes in quantified metabolites during HS-induced global I/R.Conclusions/significanceAn increase in circulating metabolites indicative of anaerobic metabolism and activation of glycolytic pathways is associated with poor prognosis after HS in rats. These same biomarkers are absent in AGS after HS with warm I/R.

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Section: Discussionmentioning

confidence: 99%

1H–NMR Metabolomic Biomarkers of Poor Outcome after Hemorrhagic Shock are Absent in Hibernators

et al. 2014

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“…(3) Sodium chloride is an isotonic solution (osmolality closer to that of human plasma) that contains equal concentrations of sodium and chloride (154mmol/L, each) and therefore has an SID equal to zero (Table 1). Experimental (14-22) (Table 2) and clinical (23-37) studies (Table 3) have suggested that resuscitation with 0.9% saline has detrimental effects on the kidneys, acid-base balance, and electrolyte homeostasis and may affect tissue perfusion, (38) inflammatory response, (14) and coagulation (dilutional coagulopathy and/or profound hyperchloremic metabolic acidosis). (27,39) …”

Section: Crystalloidsmentioning

confidence: 99%

“…Most experimental studies comparing a balanced solution, in general Ringer's lactate or Plasma-Lyte, to an unbalanced solution (0.9% saline) were performed in animal models of hemorrhagic shock (15-22) (Table 2). While resuscitation with 0.9% saline, but not with a balanced solution, led to hyperchloremic metabolic acidosis, (15-22) renal blood flow and kidney oxygen consumption were improved with Plasma-Lyte resuscitation (20) (Table 2).…”

Section: Experimental Studiesmentioning

confidence: 99%

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Balanced crystalloids for septic shock resuscitation

Corrêa

Cavalcanti

Assunção

2016

Revista Brasileira De Terapia Intensiva

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Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made. Resuscitation of septic and non-septic critically ill patients with unbalanced crystalloids, mainly 0.9% saline, has been associated with a higher incidence of acid-base balance and electrolyte disorders and might be associated with a higher incidence of acute kidney injury. This can result in greater demand for renal replacement therapy and increased mortality. Balanced crystalloids have been proposed as an alternative to unbalanced solutions in order to mitigate their detrimental effects. Nevertheless, the safety and effectiveness of balanced crystalloids for septic shock resuscitation need to be further addressed in a well-designed, multicenter, pragmatic, randomized controlled trial.

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“…Results of multiple studies involving modest to large infusion volumes have consistently found no changes in serum sodium or calcium. (Tollofsrud et al 2001;Fielding et al 2012;Valverde et al 2008;Rose et al 1980;Rohrig 2012;Rohrig et al 2014). Changes in potassium have varied between null (Tollofsrud et al 2001;Fielding et al 2012;Rose et al 1980;Rohrig et al 2014) to increased (Valverde et al 2008;Rohrig 2012) with intravenous infusion.…”

Section: Introductionmentioning

confidence: 99%

Pilot study on the effect of subcutaneous administration of lactated Ringer's solution on biochemistry parameters in healthy euvolemic cats.

Smith¹,

Greer²

2016

Veterinary Medicine & Sci

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Subcutaneous fluid administration is a commonly used therapy in veterinary practice. Its safety and efficacy have been demonstrated in human clinical studies, but have only rarely been discussed in the veterinary literature. This prospective observational study was performed to evaluate changes during a 24 h period in serum biochemistries associated with administration of lactated Ringer's solution subcutaneously to healthy cats. Lactated Ringer's solution was administered subcutaneously once to ten healthy, euvolemic cats at a dose of 22 mL kg−1. Blood biochemistry analytes were sampled at baseline and at serial time points for a total of 24 h. Changes in biochemical analytes at each time point were compared to baseline and evaluated for statistical significance. Serum blood urea nitrogen (BUN) was significantly less than baseline at 4, 6, 12, 18, and 24 h post‐infusion. Serum creatinine was significantly less than baseline at 2, 4 and 6 h. Packed cell volume (PCV) was significantly less than baseline at 6, 12, 18, and 24 h. Total plasma proteins were significantly less than baseline at all time points. Serum electrolytes did not change from baseline at any time point. Urine specific gravity was significantly increased from baseline only at 6 h post‐Lactated Ringer's solution (LRS) administration. Subcutaneous administration of lactated Ringer's solution appears to result in haemodilution with minimal change to serum electrolyte concentrations in clinically normal, euvolemic cats.

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Superiority of acetate compared with lactate in a rodent model of severe hemorrhagic shock

Cited by 22 publications

References 23 publications

1H–NMR Metabolomic Biomarkers of Poor Outcome after Hemorrhagic Shock are Absent in Hibernators

1H–NMR Metabolomic Biomarkers of Poor Outcome after Hemorrhagic Shock are Absent in Hibernators

Balanced crystalloids for septic shock resuscitation

Pilot study on the effect of subcutaneous administration of lactated Ringer's solution on biochemistry parameters in healthy euvolemic cats.

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