| Perflubron emulsion in prolonged hemorrhagic shock: influence on hepatocellular energy metabolism and oxygen-dependent gene expression. | |
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MedLine Citation:
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PMID: 12766648 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Liver dysfunction as a result of impaired oxygen availability frequently occurs following hemorrhage and contributes to delayed mortality. Artificial oxygen carriers may improve oxygen supply to vital organs while avoiding the need for allogeneic transfusion. METHODS: Rats were subjected to hemorrhagic hypotension (mean arterial pressure = 35-40 mmHg for 120 min) and were subsequently resuscitated with (1) stored whole rat blood, (2) pentastarch, or (3) pentastarch combined with perflubron emulsion (PFE; 2.7 or 5.4 g/kg body weight), a second-generation artificial oxygen carrier. Recovery of liver adenosine triphosphate, hepatocellular injury, and expression of glutamine synthetase 1, a gene that is induced by exposure of hepatocytes to low partial pressure of oxygen, were studied at 4 h of resuscitation. RESULTS: Stored whole blood or pentastarch failed to restore liver adenosine triphosphate concentrations after prolonged shock as compared to sham controls and resulted in increased gene expression of glutamine synthetase 1. Addition of 2.7 g PFE/kg restored liver adenosine triphosphate to control, whereas 5.4 g PFE/kg resulted in adenosine triphosphate concentrations significantly above control. Improved hepatocellular oxygen supply was also confirmed by restoration of the physiologic expression pattern of glutamine synthetase 1. Serum enzyme concentrations were highest after resuscitation with stored blood, whereas addition of PFE failed to further decrease enzyme concentrations as compared to pentastarch alone. CONCLUSIONS: Resuscitation with PFE is superior to stored blood or asanguineous resuscitation with respect to restoration of hepatocellular energy metabolism. The improved hepatocellular oxygen availability is reflected in normalization of oxygen-dependent gene expression. However, improved oxygen availability failed to affect early hepatocellular injury. |
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Authors:
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Markus Paxian; Hauke Rensing; Katrin Geckeis; Inge Bauer; Darius Kubulus; Donat R Spahn; Michael Bauer |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 98 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-05-26 Completed Date: 2003-06-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 1391-9 Citation Subset: AIM; IM |
Affiliation:
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Klinik für Anaesthesiologie und Intensivmedizin, Universität des Saarlandes, Hamburg, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acid-Base Equilibrium
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drug effects Adenosine Triphosphate / metabolism Animals Blood Substitutes / administration & dosage, therapeutic use* Blotting, Western Emulsions Energy Metabolism / drug effects* Fluorocarbons / administration & dosage, therapeutic use* Gene Expression / drug effects* Glutamate-Ammonia Ligase / biosynthesis, genetics Hematocrit Hepatocytes / drug effects, enzymology, metabolism* Hetastarch / therapeutic use Immunohistochemistry Liver / drug effects, enzymology, metabolism* Liver Circulation / drug effects Male Oxygen / physiology* Rats Rats, Sprague-Dawley Resuscitation Shock, Hemorrhagic / drug therapy* |
| Chemical | |
Reg. No./Substance:
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0/Blood Substitutes; 0/Emulsions; 0/Fluorocarbons; 423-55-2/perflubron; 56-65-5/Adenosine Triphosphate; 7782-44-7/Oxygen; 9005-27-0/Hetastarch; EC 6.3.1.2/Glutamate-Ammonia Ligase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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