Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model
Background: Resuscitation is the initial step for hemorrhagic shock. However, there is still controversy as to which fluid achieves the best results clinically and experimentally. Aim: It was aimed to investigate the effects of 0.9% NaCl (sodium chloride) and 6% HES (hydroxyethyl starch) on the kidn...
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| Format: | Article |
| Language: | English |
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Knowledge E
2022-04-01
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| Series: | Dubai Medical Journal |
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| Online Access: | https://www.karger.com/Article/FullText/520430 |
| _version_ | 1826906768819617792 |
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| author | Kubra Vardar Kubra Can Ugur Aksu |
| author_facet | Kubra Vardar Kubra Can Ugur Aksu |
| author_sort | Kubra Vardar |
| collection | DOAJ |
| description | Background: Resuscitation is the initial step for hemorrhagic shock. However, there is still controversy as to which fluid achieves the best results clinically and experimentally. Aim: It was aimed to investigate the effects of 0.9% NaCl (sodium chloride) and 6% HES (hydroxyethyl starch) on the kidney and blood environment. Methods: Twenty-four male Wistar rats were assigned as control, shock, and resuscitated (colloid: 6% HES and crystalloid: 0.9% NaCl) groups. Besides hemodynamics (mean arterial pressure and shock index) monitoring and kidney function evaluation, hemolysis, oxidative stress, inflammation, and glycocalyx degradation were evaluated in the plasma and kidney. Results: (1) Macrohemodynamics were successfully restored by both fluids. (2) Although 3 times more crystalloid volume was applied compared to the colloid resuscitation, similar hematocrit levels were found in both resuscitation strategies (32.8 ± 2.3 vs. 33.3 ± 1.0). (3) NaCl resuscitation led to increases in the hemolytic index, catalytic iron, and sialic acid compared to control, while HES administration increased the levels of malondialdehyde, ischemia-modified albumin, and sialic acid. (4) However, both fluid resuscitation strategies could inhibit inflammation and oxidative stress in the kidney and restore kidney function parameters. Conclusion: Although both NaCl and HES resuscitation showed protection of the kidney function against oxidative stress and inflammation, these fluids initiated the injury process. |
| first_indexed | 2024-12-12T16:23:34Z |
| format | Article |
| id | doaj.art-110327cc128b4ccd9a90b86dc8045ca5 |
| institution | Directory Open Access Journal |
| issn | 2571-726X |
| language | English |
| last_indexed | 2025-02-17T08:53:05Z |
| publishDate | 2022-04-01 |
| publisher | Knowledge E |
| record_format | Article |
| series | Dubai Medical Journal |
| spelling | doaj.art-110327cc128b4ccd9a90b86dc8045ca52025-01-02T19:14:13ZengKnowledge EDubai Medical Journal2571-726X2022-04-0111010.1159/000520430520430Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock ModelKubra Vardar0Kubra Can1Ugur Aksu2Department of Biology, Faculty of Science, University of Istanbul, Istanbul, TurkeyDepartment of Medical Microbiology, Faculty of Medicine, University of Istanbul, Istanbul, TurkeyDepartment of Biology, Faculty of Science, University of Istanbul, Istanbul, TurkeyBackground: Resuscitation is the initial step for hemorrhagic shock. However, there is still controversy as to which fluid achieves the best results clinically and experimentally. Aim: It was aimed to investigate the effects of 0.9% NaCl (sodium chloride) and 6% HES (hydroxyethyl starch) on the kidney and blood environment. Methods: Twenty-four male Wistar rats were assigned as control, shock, and resuscitated (colloid: 6% HES and crystalloid: 0.9% NaCl) groups. Besides hemodynamics (mean arterial pressure and shock index) monitoring and kidney function evaluation, hemolysis, oxidative stress, inflammation, and glycocalyx degradation were evaluated in the plasma and kidney. Results: (1) Macrohemodynamics were successfully restored by both fluids. (2) Although 3 times more crystalloid volume was applied compared to the colloid resuscitation, similar hematocrit levels were found in both resuscitation strategies (32.8 ± 2.3 vs. 33.3 ± 1.0). (3) NaCl resuscitation led to increases in the hemolytic index, catalytic iron, and sialic acid compared to control, while HES administration increased the levels of malondialdehyde, ischemia-modified albumin, and sialic acid. (4) However, both fluid resuscitation strategies could inhibit inflammation and oxidative stress in the kidney and restore kidney function parameters. Conclusion: Although both NaCl and HES resuscitation showed protection of the kidney function against oxidative stress and inflammation, these fluids initiated the injury process.https://www.karger.com/Article/FullText/5204300.9% naclhydroxyethyl starchkidneyhemorrhagic shockresuscitation |
| spellingShingle | Kubra Vardar Kubra Can Ugur Aksu Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model Dubai Medical Journal 0.9% nacl hydroxyethyl starch kidney hemorrhagic shock resuscitation |
| title | Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model |
| title_full | Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model |
| title_fullStr | Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model |
| title_full_unstemmed | Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model |
| title_short | Fluid Resuscitation Aggravates the Cellular Injury in a Hemorrhagic Shock Model |
| title_sort | fluid resuscitation aggravates the cellular injury in a hemorrhagic shock model |
| topic | 0.9% nacl hydroxyethyl starch kidney hemorrhagic shock resuscitation |
| url | https://www.karger.com/Article/FullText/520430 |
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