Fluid resuscitation increases inflammatory gene transcription after traumatic injury

Jennifer Watters, Brandon Tieu, S. Rob Todd, Terisa Jackson, Patrick J. Muller, Darren Malinoski, Martin Schreiber

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

BACKGROUND: The debate continues over type and quantity of fluid to administer for resuscitation after traumatic injury. This study aimed to examine effects of resuscitation with lactated Ringer's (LR) and Hextend (HEX) on the inflammatory response after uncontrolled hemorrhagic shock (UHS). METHODS: There were 38 swine randomized. Control swine were anesthetized and killed. Sham swine underwent laparotomy, splenectomy, and 2 hours of anesthesia. UHS swine received a grade V liver injury after laparotomy and splenectomy and were randomized to no fluid (NF) resuscitation or to blinded resuscitation 30 minutes after injury with LR or HEX. Fluids were infused as needed to maintain baseline blood pressure for 90 minutes. Lung tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony stimulating factor (G-CSF), and tumor necrosis factor alpha (TNF-α) were determined. Lung sections were examined for neutrophils (PMNs) sequestered within alveolar walls. RESULTS: All UHS animals survived and initial blood loss was similar between groups. Mean arterial pressures (MAPs) were similar for all UHS animals until resuscitation was initiated. MAPs of resuscitated animals remained similar and were significantly higher than MAPs of the NF animals. Sequestered PMNs were equally elevated in all UHS animals. Cytokine analysis showed increased IL-6, G-CSF, and TNF-α gene transcription in resuscitated swine compared with NF swine. LR and HEX resuscitated swine tissue mRNA levels showed no differences. CONCLUSIONS: Fluid resuscitation after solid organ injury and uncontrolled hemorrhage results in greater proinflammatory gene transcription than no resuscitation. LR and HEX resuscitation have equivalent effects on indices of inflammation in the lungs.

Original languageEnglish (US)
Pages (from-to)300-308
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume61
Issue number2
DOIs
StatePublished - Aug 2006

Fingerprint

Resuscitation
Hemorrhagic Shock
Swine
Wounds and Injuries
Genes
Arterial Pressure
Granulocyte Colony-Stimulating Factor
Splenectomy
Laparotomy
Interleukin-6
Tumor Necrosis Factor-alpha
Lung
Messenger RNA
Pneumonia
Neutrophils
Anesthesia
Hemorrhage
Cytokines
Blood Pressure
Ringer's lactate

Keywords

  • Colloid
  • Crystalloid
  • Cytokines
  • Hemorrhagic shock
  • Hextend
  • Inflammation
  • Lactated Ringers
  • Resuscitation

ASJC Scopus subject areas

  • Surgery

Cite this

Fluid resuscitation increases inflammatory gene transcription after traumatic injury. / Watters, Jennifer; Tieu, Brandon; Todd, S. Rob; Jackson, Terisa; Muller, Patrick J.; Malinoski, Darren; Schreiber, Martin.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 61, No. 2, 08.2006, p. 300-308.

Research output: Contribution to journalArticle

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