Abstract
Recent evidence shows that the presence of circulating neutrophils (PMNs) influences the lethal course and extent of ischemic injury associated with hemorrhagic shock. The objective of this study was to use the Wiggers shock model to investigate the correlation between the appearance of activated circulating PMNs as measured by the spontaneous reduction of nitro blue tetrazolium [(NBT)-positive PMNs] and survival rate. Rats were maintained at 35-mmHg arterial pressure for 90 min and then observed over 24 h for survival. This protocol resulted in 50% mortality. In all animals in which levels of circulating NBT-positive PMNs before bleeding were greater than 225 cells/mm3, the experimental procedure was lethal. Animals that initially had low numbers of NBT-positive PMNs (to approximately 135 cells/mm3) and maintained low counts during the hypotensive period consistently survived. Animals, which before bleeding had low NBT-positive PMN counts but during the course of hypotension significantly elevated their circulating count, have low probability for survival. In those cases in which high NBT-positive PMN counts occurred only later in the course of the hypotensive period, the rats survived. These results suggest that the number of circulating NBT-positive PMNs is a singular index for the trend toward irreversibility in this shock model.
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