Dynamic effects of adjunct peritoneal resuscitation on the early intestinal injury of rats after hemorrhagic shock

Abstract

To investigate the dynamic effects of adjunct peritoneal resuscitation ( APR ) on the early intestinal injury of rats with hemorrhagic shock, and explore its possible mechanisms. According to random number table, 96 male Wistar rats were assigned randomly into control group, shock group, Ringer solution APR group and dialysate APR group. Each group was further divided into three time points, namely 1, 2, and 6 hours after resuscitation, with 8 rats for each time point. The model of hemorrhagic shock was reproduced. The rats in the shock group received shed blood plus twice amount of normal saline as conventional intravenous resuscitation ( CIR ). Besides CIR, at the beginning of resuscitation, those rats in Ringer solution APR and dialysate APR groups were given 100 mL/kg of Ringer solution or 2.5% glucose-based peritoneal dialysis solution intravenously, respectively. The rats in four groups were sacrificed at 1, 2 and 6 hours after resuscitation, respectively. Plasma activity of diamine oxidase ( DAO ) was detected by ultraviolet spectrophotometry colorimetry. Intestinal pathological changes were observed under light microscope, and the grading of the intestinal mucosal damage ( GIMD ) score was estimated. The expressions of nuclear factor-ΚB ( NF-ΚB ) and heat shock protein 70 ( HSP70 ) mRNA in the intestinal tissue were determined with reverse transcription-polymerase chain reaction ( RT-PCR ), and the wet/dry weight ratios ( W/D ) of the remaining intestinal tissue were measured. Compared with the control group, plasma activity of DAO, GIMD score, expressions of NF-ΚB and HSP70 mRNA and W/D ratios of intestinal tissue at 1 hour after resuscitation were increased significantly in the shock group. Except the expression of NF-ΚB mRNA reached the peak level at 2 hours after resuscitation, all the other parameters increased with time. Compared with the shock group, plasma activity of DAO ( U/L: 8.78±0.76 vs. 13.30±1.37, 9.67±0.92 vs. 16.56±1.61, 10.53±0.84 vs. 18.31±1.72,all P<0.05 ), GIMD score ( 1.36±0.31 vs. 3.51±0.66, 2.28±0.40 vs. 4.02±0.76, 2.47±0.38 vs. 4.76±0.77, all P<0.05 ), the expressions of NF-ΚB mRNA in the intestine tissue ( gray value: 0.658±0.062 vs. 0.765±0.067, 0.945±0.077 vs. 1.158±0.096, 0.761±0.062 vs. 0.912±0.082, all P<0.05 ), and W/D ratios ( 3.91±0.26 vs. 4.34±0.33, 3.96±0.32 vs. 4.51±0.40, 4.37±0.33 vs. 4.99±0.43, all P<0.05 ) at 1, 2, 6 hours after resuscitation in the dialysate APR group were decreased significantly, but the expressions of HSP70 mRNA were increased significantly ( gray value: 0.717±0.054 vs. 0.635±0.056, 0.853±0.068 vs. 0.745±0.071, 1.258±0.111 vs. 1.108±0.105, all P<0.05 ). The activity of DAO and GMID score at 1 hour after resuscitation in the Ringer solution APR group were decreased significantly compared with the shock group, while the differences of the other parameters between the Ringer solution APR group and shock group showed no statistical significance. APR with 2.5% glucose-based peritoneal dialysis solution can significantly mitigate the early intestinal injury secondary to hemorrhagic shock, and the mechanism may be associated with enhancement of the expressions of HSP70 mRNA and inhibition of the expressions of NF-ΚB mRNA.