Effect of limited fluid resuscitation on mesenteric lymph circulation in rats with uncontrolled hemorrhagic shock

Abstract

Objective To examine the effect of early fluid resuscitation at different speed on mesenteric lymph circulation and learn the mechanism of limited fluid resuscitation.Methods Fortysix SD rats were subjected to uncontrolled hemorrhagic shock (UHS) by bleeding and tail amputation.The animals were assigned to sham group (n =10),UHS group (n =12),aggressive resuscitation group (n =12) and limited resuscitation group (n =12),according to random number table.Aggressive resuscitation and limited resuscitation groups were infused with Lactated Ringer' s solution at the speed of 5 ml · kg-1 · min-1 and 1 ml · kg-1 · min-1 respectively.Catheterization of the main mesenteric lymphatic duct allowed the collection of lymph fluid.Flow of mesenteric lymph fluid was recorded and levels of protein,endotoxin and TNF-α in plasma as well as lymph fluid were determined.Results At 60 minutes,the aggressive and limited resuscitation groups showed the lymph flow of (4.04±0.33) ml · kg-1 · h-1 and (1.79±0.18) ml · kg-1 · h-1 (P＜0.01) and protein output of (80.5 ±10.2) mg· kg-1 · h-1and (43.1 ±9.6) mg · kg-1 · h-1(P＜0.01).At240 minutes,the aggressive and limited resuscitation groups showed endotoxin level of (1.36 ±0.41) EU/ml and (0.81 ± 0.26) EU/ml in lymph fluid (P ＜ 0.01).At 120 minutes,the aggressive and limited resuscitation groups showed TNFα level of (3.86 ± 0.23) ng/ml and (2.63 ± 0.52) ng/ml in lymph fluid (P ＜0.01).Conclusion UHS may lead to disorder of mesenteric lymph circulation,as may be improved by the limited fluid resuscitation. Key words: Shock, hemorrhagic; Resuscitation; Mesentery; Lymph