Evaluation of Resuscitation Fluids on Endothelial Glycocalyx, Venular Blood Flow, and Coagulation Function After Hemorrhagic Shock in Rats

Abstract

Endothelial glycocalyx (EG) plays an essential role in endothelium integrity and may be compromised by hemorrhagic shock. The effects of currently available resuscitation fluids such as Hextend (HEX) or lactated Ringer s solution (LR) on vascular function and coagulation are not well understood. The aim of the present study was to compare the effects of fresh frozen plasma (FFP) with HEX or LR in their ability to repair EG structure, promote volume expansion, increase blood flow, and prevent coagulopathy. A total of 121 microvessels from cremaster muscle were studied in 32 anesthetized instrumented rats. After baseline systemic and microvascular measurements, 40% hemorrhage followed by resuscitation was performed, and measurements were repeated. Coagulation was evaluated using ROTEM to assay clot formation time, clotting time, firmness, strength, and lysis. Velocity and platelet component of strength were calculated. Fluorescein isothiocyanate or Texas Red bound to Dextrans was injected to estimate EG thickness in vivo. Our findings support the concept of cardiovascular and microvascular stabilization by infused FFP, in which the increase in microvascular perfusion associated with restored EG is essential for an optimal resuscitation strategy.

Open PDF

Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2013
Accession Number
ADA615041

Entities

People

  • Ivo T. Filho
  • Jill L. Sondeen
  • Lisa Ji
  • Luciana N. Torres
  • Michael A. Dubick

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Anticoagulants
  • Arteries
  • Blood
  • Blood Coagulation
  • Blood Coagulation Factor Inhibitors
  • Blood Coagulation Factors
  • Blood Flow
  • Blood Proteins
  • Cardiovascular Physiological Phenomena
  • Cell Membrane Structures
  • Cells
  • Cellular Structures
  • Combat Casualty Care
  • Hemorrhagic Shock
  • Laboratory Animals
  • Microvessels
  • Veins

Fields of Study

  • Medicine

Readers

  • Cardiovascular Physiology
  • Trauma Surgery or Emergency Medicine.