Effect of peritoneal resuscitation with pyruvate-based peritoneal dialysis solution on kidney injury in a rat model of hemorrhagic shock

Abstract

Objective To evaluate the effect of peritoneal resuscitation(PR)with pyruvate-based peritoneal dialysis solution(PDS)on liver injury in a rat model of hemorrhagic shock. Methods Fifty healthy male Sprague-Dawley rats, weighing 200-250 g, were used in this study.The animals were anesthetized with pentobarbital sodium, tracheostomized and mechanically ventilated.Hemorrhagic shock was induced by withdrawing blood from the left femoral artery at a rate of 0.6 ml/min within 10 min until mean arterial pressure(MAP)was reduced to 30-40 mmHg which was maintained for 60 min.The animals were divided into 5 groups(n=10 each)using a random number table: sham operation group(group SH), conventional IV resuscitation group(group CVR), PR with normal saline group(group NS), PR with lactate-based PDS group(group LA)and PR with pyruvate-based PDS group(group PY). The animals only underwent surgical procedure in group SH.In group CVR, the animals were resuscitated with infusion of the blood withdrawn and normal saline(the volume was 2 times volume of blood loss)via the right femoral artery after successful establishment of hemorrhagic shock.In NS, LA and PY groups, conventional resuscitation was performed, and the animals were simultaneously resuscitated with normal saline, 2.5% glucose-based PDS containing lactate, and 2.5% glucose-based PDS containing pyruvate 20 ml, respectively.The blood withdrawn and fluid for resuscitation were all infused over 30 min.MAP was recorded before blood letting, at 5, 30 and 60 min of shock and at 5, 30, 60, 90 and 120 min after the end of resuscitation.The arterial blood lactate level was measured by chemical colorimetry at 120 min after the end of resuscitation.The animals were then sacrificed and livers were removed for examination of the pathological changes with a light microscope.The damage to livers was assessed and scored. Results Compared with MAP before blood letting, MAP was significantly decreased during hemorrhagic shock and increased at each time point after resuscitation in CVR, NS, LA and PY groups(P 0.05). Compared with group LA, the arterial blood lactate level and liver damage scores were significantly decreased in group PY(P<0.05). Conclusion PR with pyruvate-based PDS can reduce liver injury in a rat model of hemorrhagic shock. Key words: Pyruvic acid; Peritoneal dialysis; Resuscitation; Shock, hemorrhagic; Liver