The effect of non-insulin dependent diabetes mellitus on uncontrolled hemorrhage in a rodent model

Abstract

Objective: Diabetes mellitus (DM) is an independent risk factor for higher morbidity and mortality rates from trauma. We tested the null hypothesis that there would be no difference in the hemorrhage volumes and hemodynamic responses to uncontrolled hemorrhage between Zucker Diabetic Fat rats (ZDF) and euglycemic Sprague–Dawley rats (SD). Methods: Twenty-four adult male rats (12 ZDF and 12 SD) were anesthetized with althesin via the intraperitoneal route. The femoral artery was cannulated by cut-down to monitor the heart rate (HR), mean arterial pressure (MAP) and to obtain blood samples for blood gas analysis. Twelve rats (6 ZDF and 6 SD) underwent uncontrolled hemorrhage by 50% tail amputation. Twelve rats (6 ZDF and 6 SD) served as non-hemorrhage controls. The HR, MAP, lactate (LAC), glucose levels (GL) and cumulative hemorrhage volume (CHV) were measured pre-hemorrhage and then every 15 min post-hemorrhage for 120 min. Data were reported as mean ± S.E.M. Group comparisons were analyzed by ANOVA with repeated values; post hoc testing by Bonferroni (all tests were two-tailed, alpha = 0.05). Results: Pre-hemorrhage the SD and ZDF were evenly matched for LAC, HR and MAP. CHV (cm 3/100 g) was significantly ( p = 0.008) greater in the ZDF (1.49 ± 0.12) as compared to the SD (0.38 ± 0.11). The ZDF had significantly ( p < 0.001) higher LAC (7.96 ± 0.61 mmol/L) than the SD (2.0 ± 0.41 mmol/L). Conclusion: DM as compared to non-DM rats suffered a greater blood loss with a more severe lactic acidosis after a comparable uncontrolled vascular injury.