Systemic and Microvascular Effects of Resuscitation with Blood Products After Severe Hemorrhage in Rats
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
Pagination or Media Count:
Severe hemorrhage is associated with the disruption of the endothelial glycocalyx EG, a key component of the endothelium. The effects of blood components on the EG are unknown. The present study furthers our investigations into the effects of resuscitation with blood products on the skeletal muscle microcirculation of hemorrhaged rats, focusing on packed red blood cells PRBCs or fresh whole blood FWB. Rats were bled 40 of total blood volume and resuscitated with 11 PRBClactated Ringer s solution LR, 11 washed PRBC wPRBCLR, FWB or LR only. Sham animals were subjected to all procedures except hemorrhage and resuscitation. EG thickness, blood flow, and microvascular permeability were studied using intravital microscopy. Hemodynamics and coagulation tests rotational thromboelastometry were performed. After severe hemorrhage, EG and permeability were restored to sham levels in the PRBCLR and FWB groups, but not in the wPRBC LR or LR groups. Clotting time was longer and clot elasticity and firmness were reduced in wPRBCLR and LR, but not in FWB or PRBCLR groups when compared with sham. Resuscitation with FWB or PRBCLR was superior in reversing coagulopathy, restoring EG and permeability changes following hemorrhage, compared with wPRBCLR or LR alone. As wPRBCLR did not improve EG and permeability, these data suggest that the removal of residual plasma protein from wPRBC or resuscitation with a protein-free solution LR is not able to improve microcirculation and coagulation functions in this severe hemorrhage model.
- Medicine and Medical Research