Hypertonic Saline Infusion Minimizes Bacterial Translocation and Degenerative Changes in Liver of Shocked Rats

Abstract

Background: The hypertonic saline (HTS) solutions have recently gained widespread acceptance in control of shock. Aim of the work: The aim of this work is to study the use of hypertonic saline with the resuscitation fluids in rats with induced hemorrhagic shock to evaluate the impact of this solution on the extent of early bacterial translocation, blood pressure, and histopathological liver changes. Materials and methods: sixty phenobarbital anesthetized rats were involved in this study where they were allowed to bleed. Arterial pressure was maintained below 50 mm Hg for 30 minutes. They were randomized into 2 groups, each of 30 rats. Resuscitation in group I was done by using Lactated Ringer's (LR) solution (60 ml/Kg) and in group II HTS 7.5% in a dose of 4 ml /kg body weight was added to Lactated Ringer's (LR) solution (60 ml/Kg). Regular monitoring of blood pressure was done and blood samples were withdrawn 1, 30, and 90 minutes and 6 hours after commencement of the resuscitation and sent for blood culture for both aerobic and anaerobic growths. After 24 hours the liver was resected and sent for histological examination. Results: The mean arterial blood pressure in group I before resuscitation was found to be about 48±11 mm Hg and it was raised to a mean of 90±8 mm Hg after 2 hours of resuscitation with LR alone. In group II, the mean arterial blood pressure was found to be 49±5 mm Hg and it was efficiently controlled by HTS with LR and 2 hours after commencement of resuscitation it was elevated to 114±10 mm Hg. The blood cultures were positive in 3.3% of the rats of group II and in 40% of rats of group I. Escherichia coli were the most commonly isolated organism. Histopathological findings showed inflammatory process and early severe hepatocyte degeneration of the liver of group I rats and these changes were absent or minimal in group II. Conclusion: hypertonic saline was found to be effective for decreasing the rate of early bacterial translocation to blood and also for more efficient restoring of the mean arterial pressure in rats with induced hemorrhagic shock; in addition, HTS infusion minimizes the inflammatory and degenerative process in liver.