Pyruvate-fortified fluid resuscitation improves hemodynamic stability while suppressing systemic inflammation and myocardial oxidative strees after hemorrhagic shock

Devin C. Flaherty, Besim Hoxha, Jie Sun, Hunaid Gurji, Jerry Simecka, Robert T. Mallet, Albert Yurvati

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Abstract

Objectives: To determine whether controlled resuscitation with pyruvale-fortified Ringer's (PR) solution vs. conventional lactate Ringer's (LR) more effectively stabilizes mean arterial pressure (MAP) and suppresses myocardial inflammation postresuscitation. Methods: Goats were hemorrhaged (255 ± 22 ml) to lower MAP to 48 ± 1 mmHg, Next, the right femoral vessels were occluded for 90 min to model tourniquet application. Beginning at 30 min occlusion. LR or PR was infused iv at 10 ml/min for 90 min. The femoral occlusions were released at 60 min infusion. Results: At 4 h postocclusion, MAP (mmHg) was increased in PR (59 ± 4) vs. LR (47 ± 3) resuscitated goats (p < 0.05). PR also more effectively augmented circulating HCO 3- and total base excess. Nitrosative stress, detected in myocardium 4 h after LR resuscitation, was suppressed by PR. Finally, PR prevented the increase in circulating neutrophils that accompanied LR resuscitation. Conclusions: Relative to LR, resuscitation with PR more effectively stabilized MAP. suppressed myocardial nitrosative stress and minimized systemic inflammation after hemorrhagic shock with hindlimb ischemia-reperfusion.

Original languageEnglish
Pages (from-to)166-172
Number of pages7
JournalMilitary Medicine
Volume175
Issue number3
DOIs
StatePublished - 1 Jan 2010

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Hemorrhagic Shock
Pyruvic Acid
Resuscitation
Hemodynamics
Inflammation
Arterial Pressure
Thigh
Goats
Tourniquets
Hindlimb
Reperfusion
Ringer's lactate
Myocardium
Neutrophils
Ischemia

Cite this

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title = "Pyruvate-fortified fluid resuscitation improves hemodynamic stability while suppressing systemic inflammation and myocardial oxidative strees after hemorrhagic shock",
abstract = "Objectives: To determine whether controlled resuscitation with pyruvale-fortified Ringer's (PR) solution vs. conventional lactate Ringer's (LR) more effectively stabilizes mean arterial pressure (MAP) and suppresses myocardial inflammation postresuscitation. Methods: Goats were hemorrhaged (255 ± 22 ml) to lower MAP to 48 ± 1 mmHg, Next, the right femoral vessels were occluded for 90 min to model tourniquet application. Beginning at 30 min occlusion. LR or PR was infused iv at 10 ml/min for 90 min. The femoral occlusions were released at 60 min infusion. Results: At 4 h postocclusion, MAP (mmHg) was increased in PR (59 ± 4) vs. LR (47 ± 3) resuscitated goats (p < 0.05). PR also more effectively augmented circulating HCO 3- and total base excess. Nitrosative stress, detected in myocardium 4 h after LR resuscitation, was suppressed by PR. Finally, PR prevented the increase in circulating neutrophils that accompanied LR resuscitation. Conclusions: Relative to LR, resuscitation with PR more effectively stabilized MAP. suppressed myocardial nitrosative stress and minimized systemic inflammation after hemorrhagic shock with hindlimb ischemia-reperfusion.",
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Pyruvate-fortified fluid resuscitation improves hemodynamic stability while suppressing systemic inflammation and myocardial oxidative strees after hemorrhagic shock. / Flaherty, Devin C.; Hoxha, Besim; Sun, Jie; Gurji, Hunaid; Simecka, Jerry; Mallet, Robert T.; Yurvati, Albert.

In: Military Medicine, Vol. 175, No. 3, 01.01.2010, p. 166-172.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Pyruvate-fortified fluid resuscitation improves hemodynamic stability while suppressing systemic inflammation and myocardial oxidative strees after hemorrhagic shock

AU - Flaherty, Devin C.

AU - Hoxha, Besim

AU - Sun, Jie

AU - Gurji, Hunaid

AU - Simecka, Jerry

AU - Mallet, Robert T.

AU - Yurvati, Albert

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Objectives: To determine whether controlled resuscitation with pyruvale-fortified Ringer's (PR) solution vs. conventional lactate Ringer's (LR) more effectively stabilizes mean arterial pressure (MAP) and suppresses myocardial inflammation postresuscitation. Methods: Goats were hemorrhaged (255 ± 22 ml) to lower MAP to 48 ± 1 mmHg, Next, the right femoral vessels were occluded for 90 min to model tourniquet application. Beginning at 30 min occlusion. LR or PR was infused iv at 10 ml/min for 90 min. The femoral occlusions were released at 60 min infusion. Results: At 4 h postocclusion, MAP (mmHg) was increased in PR (59 ± 4) vs. LR (47 ± 3) resuscitated goats (p < 0.05). PR also more effectively augmented circulating HCO 3- and total base excess. Nitrosative stress, detected in myocardium 4 h after LR resuscitation, was suppressed by PR. Finally, PR prevented the increase in circulating neutrophils that accompanied LR resuscitation. Conclusions: Relative to LR, resuscitation with PR more effectively stabilized MAP. suppressed myocardial nitrosative stress and minimized systemic inflammation after hemorrhagic shock with hindlimb ischemia-reperfusion.

AB - Objectives: To determine whether controlled resuscitation with pyruvale-fortified Ringer's (PR) solution vs. conventional lactate Ringer's (LR) more effectively stabilizes mean arterial pressure (MAP) and suppresses myocardial inflammation postresuscitation. Methods: Goats were hemorrhaged (255 ± 22 ml) to lower MAP to 48 ± 1 mmHg, Next, the right femoral vessels were occluded for 90 min to model tourniquet application. Beginning at 30 min occlusion. LR or PR was infused iv at 10 ml/min for 90 min. The femoral occlusions were released at 60 min infusion. Results: At 4 h postocclusion, MAP (mmHg) was increased in PR (59 ± 4) vs. LR (47 ± 3) resuscitated goats (p < 0.05). PR also more effectively augmented circulating HCO 3- and total base excess. Nitrosative stress, detected in myocardium 4 h after LR resuscitation, was suppressed by PR. Finally, PR prevented the increase in circulating neutrophils that accompanied LR resuscitation. Conclusions: Relative to LR, resuscitation with PR more effectively stabilized MAP. suppressed myocardial nitrosative stress and minimized systemic inflammation after hemorrhagic shock with hindlimb ischemia-reperfusion.

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