Effects of oral rehydration with pyruvate-glucose-electrolyte solution on hemodynamics and tissue perfusion in resuscitation of hemorrhagic shock in rats with 45% blood volume loss

Abstract

Objective To study the effects of oral rehydration with glucose-electrolyte solution containing sodium pyruvate on early hemodynamics and tissue perfusion in hemorrhagic shock rats with 45% blood volume loss. Methods Male Sprague-Dawley (SD) rats underwent surgical catheter placements(at sites of stomach, left femoral artery and vein)were divided into three groups by means of random number table: hemorrhagic shock without rehydration (NR group, n=20), hemorrhagic shock and oral administration of pyruvate-glucose-electrolyte solution (PGES group, n=20), hemorrhagic shock and oral administration of bicarbonate-glucose-electrolyte solution (BGES group, n=20). All rats in above three groups were bled about 45% total blood volume in 5 minutes twice with an interval of 15 minutes. Another 10 rats without hemorrhage were followed by a control study (NH group, n=10). Rats in PGES group and BGES group were fed with PGES or BGES at 0.5 h after bleeding by twice of the blood loss volume. The mean arterial pressure (MAP) and organ (liver, kidney and intestinal mucosal) blood flow were measured before bleeding and at 0, 1, 2, 4 h after bleeding, and the mortality within 24 hours was also analyzed. The data were analyzed by F test, t test or Kruskal-Wallis rank test, and the survival rate was analyzed by log-rank test, there was statistical difference with P<0.05. Results All rats in NH group were alive at 24 h, and the survival rates within 24 h were 4.2%, 20.8% and 45.8% in the NR group, BGES group and PGES group respectively. There was significant difference between each two groups(with P values below 0.05). The MAP and the organ blood flows were decreased continuously in the rats after bleeding. In NR group, the MAP rose to a certain extent at 1 h after hemorrhage, then consecutively decreasing until death. The experimental results also show that, compared with NR group, the MAP and organ blood flows in rats of BGES group and PGES group both had a certain degree of elevation at each timepoint after hemorrhage, both MAP and organ blood flows in the PGES group were significantly higher than that in the BGES group at 1, 2, 4 h after hemorrhagic shock, the differences were statistically significant (with P values below 0.05). Conclusions Oral rehydration with glucose-electrolyte solution containing sodium pyruvate can significantly improve hemodynamics and organ perfusion in 45% blood volume hemorrhagic shock rats, and the effect is better than that of bicarbonate-containing oral rehydration solution. Oral rehydration with pyruvate-glucose-electrolyte solution may play a certain role in the treatment of hemorrhagic shock. Key words: Pyruvic acid; Shock, hemorrhagic; Fluid therapy; Hemodynamics; Rats; Tissue perfusion