Document Detail

Hypertonic saline resuscitation enhances blood pressure recovery and decreases organ injury following hemorrhage in acute alcohol intoxicated rodents.
MedLine Citation:
PMID:  23147176     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Acute alcohol intoxication (AAI) impairs the hemodynamic and arginine vasopressin (AVP) counter-regulation to hemorrhagic shock (HS) and lactated Ringer's solution (LR) fluid resuscitation (FR). The mechanism of AAI-induced suppression of AVP release in response to HS involves accentuated nitric oxide (NO) inhibitory tone. In contrast, AAI does not prevent AVP response to increased osmolarity produced by hypertonic saline (HTS) infusion. We hypothesized that FR with HTS during AAI would enhance AVP release by decreasing periventricular nucleus NO inhibitory tone, subsequently improving mean arterial blood pressure (MABP) and organ perfusion.
METHODS: Male Sprague-Dawley rats received a 15-hour alcohol infusion (2.5 g/kg + 0.3 g/kg/h) or dextrose (DEX) before HS (40 mm Hg × 60 minutes) and FR with HTS (7.5%, 4 ml/kg) or LR (2.4 × blood volume removed). Organ blood flow was determined, and brains were collected for NO content at 2 hours after FR.
RESULTS: HTS improved MABP recovery in AAI (109 vs. 80 mm Hg) and DEX (114 vs. 83 mm Hg) animals compared with LR. This was associated with higher (>60%) circulating AVP levels at 2 hours after FR compared with those detected in LR animals in both groups. Neither AAI alone nor HS in DEX animals resuscitated with LR altered organ blood flow. In AAI animals, HS and FR with LR reduced blood flow to the liver (72%), small intestine (65%), and large intestine (67%) compared with shams. FR with HTS improved liver (threefold) and small intestine (twofold) blood flow compared with LR in AAI-HS animals. The enhanced MABP response to HTS was prevented by pretreatment with a systemic AVP V1a receptor antagonist. HTS decreased periventricular nucleus NO content in both groups 2 hours after FR.
CONCLUSION: These results suggest that FR with HTS in AAI results in the removal of central NO inhibition of AVP, restoring AVP levels and improving MABP and organ perfusion in AAI-HS.
Jesse K Sulzer; Annie M Whitaker; Patricia E Molina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  74     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-28     Completed Date:  2013-03-21     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  196-202     Citation Subset:  AIM; IM    
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MeSH Terms
Alcoholic Intoxication / complications,  physiopathology,  therapy*
Arginine Vasopressin / blood
Blood Pressure*
Intestines / blood supply
Isotonic Solutions
Kidney / blood supply
Liver / blood supply
Nitric Oxide / blood
Peroxidase / blood
Rats, Sprague-Dawley
Regional Blood Flow
Saline Solution, Hypertonic / therapeutic use*
Shock, Hemorrhagic / complications,  physiopathology,  therapy*
Grant Support
Reg. No./Substance:
0/Isotonic Solutions; 0/Saline Solution, Hypertonic; 113-79-1/Arginine Vasopressin; 31C4KY9ESH/Nitric Oxide; 8022-63-7/Ringer's lactate; EC

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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