(The) effectiveness of hypertonic saline and pentoxifylline (HTS-PTX) resuscitation in hemorrhagic shock and sepsis tissue injury : comparison with LR, HES, and LR-PTX treatments

다국어 초록 (Multilingual Abstract)

The effectiveness of hypertonic saline and pentoxifyline(HSPTX) resuscitation in hemorrhagic shock and sepsis tissue injury comparison with the LR, HES-HTS, LR-PTX treatments

Purpose: to compare the organs (lung and liver) injury and laboratory results of hemorrhagic shock and sepsis models with various treatments; HTSPTX, RLPTX, HESHTS and RL.
Methods: Male Sprague-Dawley rats (200？290g, Charles-River, St. Constant, Canada) were used this study and they were randomly assigned to one of the four groups (n = 16 per group) to receive the following treatments: (1) lactated Ringer's solution group (LR); (2) 7.5% hypertonic saline with hydroxyethyl starch group (HTS-HES); (3) lactated Ringer's (LR) solution with PTX group (LR-PTX); and (4) 7.5% hypertonic saline with PTX group (HTS-PTX) and each group was divided to one of the two following event models; (1) hemorrhagic shock (n = 8); (2) sepsis (n = 8). The venous catheter was utilized for injection of resuscitative fluids, and the arterial catheter was used to withdraw blood and monitor the mean arterial pressure (MAP) by MacLab？ (PowerMac, AD Instruments, Australia). Organ (lung and liver) histologiy study, Bronchoalveolar lavage (BAL) and Cytokine test were performed.
Results: Mean lung injury score is 1.7. Total leukocyte count in the BAL 24 h after treatment was significantly higher in LR treated sepsis model (10 x 106 ±0.8) as compared to other sepsis treatment models (HTS-HES; 6 x 106 ± 1.2, LR-PTX; 5 x 106 ± 1.5, HTS-PTX; 5 x 106 ± 0.6)(p<0.05). The higher total leukocyte count in the LR sepsis model (17 ±1.5 %) is due to an increased number of neutrophils, as compared to other sepsis treatment models (HTS-HES; 6 ± 0.8 %, LR-PTX; 10 ± 1.3 %, HTS-PTX; 5 ± 0.4 %%). The total hepatic injury score in sepsis model was significantly greater in the LR group (9.9 ± 0.5) than either the other treatment groups (HTS-HES; 6.7 ±0.8, LR-PTX; 5.6 ± 0.7, HTS-PTX; 3.1 ± 0.9, respectively; p < 0.05). Also, in shock model, LR group (10.6 ± 2.1) was significantly higer (HTS-HES; 5.8 ±0.9, LR-PTX; 7.3 ±0.9, HTS-PTX; 3.5 ± 0.9, respectively; p < 0.05). HTSPTX resuscitation resulted in a 49% decrease in TNF-α, a 29% decrease in IL-1β, and a 58% decrease in IL-6 at 24 hours when compared with RL in shock model (p < 0.05) and, in sepsis model, in a 45% derease in TNF-α, a 24% decrease in IL-1β, and a 35% decrease in IL-6 at 24 hours when compared with LR (p < 0.05).
Conclusion: HTS-PTX may have most advantage over other proposed resuscitation strategies and LR-PTX or HTS-HES was better results than LR therapy.