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Titel: Comparative Effects of Crystalloid and Small Volume Hypertonic Hyperoncotic Fluid Resuscitation on Hepatic Microcirculation after Hemorrhagic Shock
Autor: auer, M. Marzi, I. Ziegenfuss, T. Seeck, G. Buhren, V. Larsen, R.
Mediengruppe: journal article
Herausgeber: ---
Zeitschrift: Circulatory Shock
Jahr: 1993
Band: 40
Heft: 3
Seiten: 187-193
Sprache: English
Abstract: Hepatic microcirculation, leukocyte-endothelial interaction, and sinusoidal widths were studied by means of intravital microscopy in a non-heparinized fixed pressure hemorrhagic shock model in the rat. Asanguineous resuscitation was performed either with ''adequate'' amounts of lactated Ringer's solution (threefold shed volume/30 min) or 4 ml/kg/3 min 7.2% saline/10% Dextran 60 (HSDex) or 4 ml/kg/3 min 7.2% saline/10% hydroxyethylstarch 200/0.62 (HSHes). Hemorrhagic shock and resuscitation was paralleled by significant (P < 0.01) lumenal narrowing of sinusoids that remained largely uninfluenced by the type of fluid used for resuscitation (HSDex: 9.28 +/- 0.56; HSHes: 8.93 +/- 0.29, LR: 8.87 +/- 0.6 mum compared to 12.17 +/- 0.24 mum in controls). Whereas HSHes and LR-therapy resulted in comparably increased leukocyte adhesion to the sinusoidal wall, the dextran-containing solution led to a significant attenuation of leukocyte-endothelial interaction, suggesting involvement of dextran-binding adhesion molecules, e.g., selectins. (C) 1993 Wiley-Liss, Inc.