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Models of hemorrhagic shock: Differences in the physiological and inflammatory response.
MedLine Citation:
PMID:  23178149     Owner:  NLM     Status:  Publisher    
INTRODUCTION: The hemorrhagic shock (HS) model is commonly used to initiate a systemic post-traumatic inflammatory response. Numerous experimental protocols exist and it is unclear how differences in these models affect the immune response making it difficult to compare results between studies. The aim of this study was to compare the inflammatory response of different established protocols for volume-controlled shock in a murine model. METHODS: Male C57/BL6 mice 6-10weeks and weighing 20-25g were subjected to volume-controlled or pressure-controlled hemorrhagic shock. In the volume-controlled group 300μl, 500μl, or 700μl blood was collected over 15min and mean arterial pressure was continuously monitored during the period of shock. In the pressure-controlled hemorrhagic shock group, blood volume was depleted with a goal mean arterial pressure of 35mmHg for 90min. Following hemorrhage, mice from all groups were resuscitated with the extracted blood and an equal volume of lactated ringer solution. Six hours from the initiation of hemorrhagic shock, serum IL-6, KC, MCP-1 and MPO activity within the lung and liver tissue were assessed. RESULTS: In the volume-controlled group, the mice were able to compensate the initial blood loss within 30min. Approximately 800μl of blood volume was removed to achieve a MAP of 35mmHg (p<0.001). No difference in the pro-inflammatory cytokine (IL-6 and KC) profile was measured between the volume-controlled groups (300μl, 500μl, or 700μl). The pressure-controlled group demonstrated significantly higher cytokine levels (IL-6 and KC) than all volume-controlled groups. Pulmonary MPO activity increased with the severity of the HS (p<0.05). This relationship could not be observed in the liver. CONCLUSION: Volume-controlled hemorrhagic shock performed following current literature recommendations may be insufficient to produce a profound post-traumatic inflammatory response. A decrease in the MAP following blood withdrawal (300μl, 500μl or 700μl) was usually compensated within 30min. Pressure-controlled hemorrhagic shock is a more reliable for induction of a systemic inflammatory response.
Roman Pfeifer; Philipp Lichte; Helen Schreiber; Richard M Sellei; Thomas Dienstknecht; Cameron Sadeghi; Hans-Christoph Pape; Philipp Kobbe
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-21
Journal Detail:
Title:  Cytokine     Volume:  -     ISSN:  1096-0023     ISO Abbreviation:  Cytokine     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005353     Medline TA:  Cytokine     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Department of Orthopaedics and Trauma Surgery, Aachen University Medical Center, Aachen, Germany. Electronic address:
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