The influence of hypotensive resuscitation strategy on gut and lung injury in a rat model of uncontrolled hemorrhagic shock

Abstract

Objective To investigate the effect of hypotensive resuscitation strategies on the hemorrhagic shock-induced gut and lung injury in an uncontrolled hemorrhagic-shock rat model. Methods Uncontrolled hemorrhagic-shock Sprague-Dawley male rats (n = 16;8 rats per group) were randomly assigned to normotensive resuscitation group ( group Ⅰ ) and hypotensive resuscitation group ( group Ⅱ ). 3h after resuscitation,gut injury and lung injury was assessed. Results The percentage of villous injury in group Ⅰwas ( 33. 13 ± 2. 17 ) %, while it was ( 12. 38 ± 1.69 ) % ( P ＜ 0. 05 ). The incidence of bacterial translocation in both groups was 87.5% (7/8) and 25.0% ( 2/8 ) respectively ( P ＜ 0.05 ). The percentage of Evan' s blue leakage was ( 3.03 ± 0. 28 ) % in group Ⅰ , whereas it was ( 1.25 ± 0. 17 ) % in group Ⅱ ( P ＜0. 05). The lung permeability index in both groups was 0. 140 ± 0. 018 and 0. 085 ± 0. 004 respectively (P＜0.05). Myeloperoxidase (MPO) activity in group Ⅰ was significantly higher than in group Ⅱ,(16.4±2.6) u/gvs(33.8±2.1) u/g(P＜0.05). Conclusion In severe and uncontrolled hemorrhagic shock, hypotensive resuscitation before definitive hemorrhage control is achieved is superior to normotensive resuscitation as it decreases both gut and lung injuries. Key words: Uncontrolled hemorrhagic shock; Resuscitation; Gut injury; Lung injury