Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
Abstract Fluid resuscitation following severe inflammation-induced hypoperfusion is critical for the restoration of hemodynamics and the prevention of multiorgan dysfunction syndrome during septic shock. Fluid resuscitation with commercially available crystalloid and colloid solutions only provides...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-90431-z |
| _version_ | 1818424834539913216 |
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| author | Donald A. Belcher Alexander T. Williams Andre F. Palmer Pedro Cabrales |
| author_facet | Donald A. Belcher Alexander T. Williams Andre F. Palmer Pedro Cabrales |
| author_sort | Donald A. Belcher |
| collection | DOAJ |
| description | Abstract Fluid resuscitation following severe inflammation-induced hypoperfusion is critical for the restoration of hemodynamics and the prevention of multiorgan dysfunction syndrome during septic shock. Fluid resuscitation with commercially available crystalloid and colloid solutions only provides transient benefits, followed by fluid extravasation and tissue edema through the inflamed endothelium. The increased molecular weight (M.W.) of polymerized human serum albumin (PolyHSA) can limit fluid extravasation, leading to restoration of hemodynamics. In this prospective study, we evaluated how fluid resuscitation with PolyHSA impacts the hemodynamic and immune response in a lipopolysaccharide (LPS) induced endotoxemia mouse model. Additionally, we evaluated fluid resuscitation with PolyHSA in a model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Resuscitation with PolyHSA attenuated the immune response and improved the maintenance of systemic hemodynamics and restoration of microcirculatory hemodynamics. This decrease in inflammatory immune response and maintenance of vascular wall shear stress likely contributes to the maintenance of vascular integrity following fluid resuscitation with PolyHSA. The sustained restoration of perfusion, decrease in pro-inflammatory immune response, and improved vascular integrity that results from the high M.W. of PolyHSA indicates that a PolyHSA based solution is a potential resuscitation fluid for endotoxic and septic shock. |
| first_indexed | 2024-12-14T14:04:20Z |
| format | Article |
| id | doaj.art-c975693a2e82403babdaba58ccc0bc55 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T14:04:20Z |
| publishDate | 2021-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-c975693a2e82403babdaba58ccc0bc552022-12-21T22:58:37ZengNature PortfolioScientific Reports2045-23222021-05-0111111310.1038/s41598-021-90431-zPolymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsisDonald A. Belcher0Alexander T. Williams1Andre F. Palmer2Pedro Cabrales3William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State UniversityDepartment of Bioengineering, University of California San DiegoWilliam G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State UniversityDepartment of Bioengineering, University of California San DiegoAbstract Fluid resuscitation following severe inflammation-induced hypoperfusion is critical for the restoration of hemodynamics and the prevention of multiorgan dysfunction syndrome during septic shock. Fluid resuscitation with commercially available crystalloid and colloid solutions only provides transient benefits, followed by fluid extravasation and tissue edema through the inflamed endothelium. The increased molecular weight (M.W.) of polymerized human serum albumin (PolyHSA) can limit fluid extravasation, leading to restoration of hemodynamics. In this prospective study, we evaluated how fluid resuscitation with PolyHSA impacts the hemodynamic and immune response in a lipopolysaccharide (LPS) induced endotoxemia mouse model. Additionally, we evaluated fluid resuscitation with PolyHSA in a model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Resuscitation with PolyHSA attenuated the immune response and improved the maintenance of systemic hemodynamics and restoration of microcirculatory hemodynamics. This decrease in inflammatory immune response and maintenance of vascular wall shear stress likely contributes to the maintenance of vascular integrity following fluid resuscitation with PolyHSA. The sustained restoration of perfusion, decrease in pro-inflammatory immune response, and improved vascular integrity that results from the high M.W. of PolyHSA indicates that a PolyHSA based solution is a potential resuscitation fluid for endotoxic and septic shock.https://doi.org/10.1038/s41598-021-90431-z |
| spellingShingle | Donald A. Belcher Alexander T. Williams Andre F. Palmer Pedro Cabrales Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis Scientific Reports |
| title | Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis |
| title_full | Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis |
| title_fullStr | Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis |
| title_full_unstemmed | Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis |
| title_short | Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis |
| title_sort | polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis |
| url | https://doi.org/10.1038/s41598-021-90431-z |
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