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

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.