Resuscitation with lactated Ringer's does not increase inflammatory response in a swine model of uncontrolled hemorrhagic shock

Jennifer Watters, Susan I. Brundage, S. Rob Todd, Nathan A. Zautke, J. A. Stefater, J. C. Lam, Patrick J. Muller, Darren Malinoski, Martin Schreiber

    Research output: Contribution to journalArticle

    30 Citations (Scopus)

    Abstract

    Lactated Ringer's (LR) and normal saline (NS) are widely and interchangeably used for resuscitation of trauma victims. Studies show LR to be superior to NS in the physiologic response to resuscitation. Recent in vitro studies demonstrate equivalent effects of LR and NS on leukocytes. We aimed to determine whether LR resuscitation would produce an equivalent inflammatory response compared with normal saline (NS) resuscitation in a clinically relevant swine model of uncontrolled hemorrhagic shock. Thirty-two swine were randomized. Control animals (n = 6) were sacrificed following induction of anesthesia for baseline data. Sham animals (n = 6) underwent laparotomy and 2 h of anesthesia. Uncontrolled hemorrhagic shock animals (n = 10/group) underwent laparotomy, grade V liver injury, and blinded resuscitation with LR or NS to maintain baseline blood pressure for 1.5 h before sacrifice. Lung was harvested, and tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-α) were determined using quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). Sections of lung were processed and examined for neutrophils sequestered within the alveolar walls. Cytokine analysis showed no difference in IL-6 gene transcription in any group (P = 0.99). Resuscitated swine had elevated G-CSF and TNF-α gene transcription, but LR and NS groups were not different from each other (P = 0.96 and 0.10, respectively). Both resuscitation groups had significantly more alveolar neutrophils present than controls (P <0.01) and shams (P <0.05) but were not different from one another (P = 0.83). LR and NS resuscitation have equivalent effects on indices of inflammation in the lungs in our model of uncontrolled hemorrhagic shock.

    Original languageEnglish (US)
    Pages (from-to)283-287
    Number of pages5
    JournalShock
    Volume22
    Issue number3
    DOIs
    StatePublished - Sep 2004

    Fingerprint

    Hemorrhagic Shock
    Resuscitation
    Swine
    Granulocyte Colony-Stimulating Factor
    Laparotomy
    Interleukin-6
    Neutrophils
    Anesthesia
    Tumor Necrosis Factor-alpha
    Lung
    Wounds and Injuries
    Ringer's lactate
    Reverse Transcriptase Polymerase Chain Reaction
    Genes
    Pneumonia
    Leukocytes
    Cytokines
    Blood Pressure
    Messenger RNA
    Liver

    Keywords

    • Cytokines
    • G-CSF
    • IL-6
    • Neutrophils
    • Normal saline
    • TNF-α

    ASJC Scopus subject areas

    • Critical Care and Intensive Care Medicine
    • Physiology

    Cite this

    Resuscitation with lactated Ringer's does not increase inflammatory response in a swine model of uncontrolled hemorrhagic shock. / Watters, Jennifer; Brundage, Susan I.; Todd, S. Rob; Zautke, Nathan A.; Stefater, J. A.; Lam, J. C.; Muller, Patrick J.; Malinoski, Darren; Schreiber, Martin.

    In: Shock, Vol. 22, No. 3, 09.2004, p. 283-287.

    Research output: Contribution to journalArticle

    Watters, Jennifer ; Brundage, Susan I. ; Todd, S. Rob ; Zautke, Nathan A. ; Stefater, J. A. ; Lam, J. C. ; Muller, Patrick J. ; Malinoski, Darren ; Schreiber, Martin. / Resuscitation with lactated Ringer's does not increase inflammatory response in a swine model of uncontrolled hemorrhagic shock. In: Shock. 2004 ; Vol. 22, No. 3. pp. 283-287.
    @article{ff48ad7ff324486dbc8307b8cc5efde8,
    title = "Resuscitation with lactated Ringer's does not increase inflammatory response in a swine model of uncontrolled hemorrhagic shock",
    abstract = "Lactated Ringer's (LR) and normal saline (NS) are widely and interchangeably used for resuscitation of trauma victims. Studies show LR to be superior to NS in the physiologic response to resuscitation. Recent in vitro studies demonstrate equivalent effects of LR and NS on leukocytes. We aimed to determine whether LR resuscitation would produce an equivalent inflammatory response compared with normal saline (NS) resuscitation in a clinically relevant swine model of uncontrolled hemorrhagic shock. Thirty-two swine were randomized. Control animals (n = 6) were sacrificed following induction of anesthesia for baseline data. Sham animals (n = 6) underwent laparotomy and 2 h of anesthesia. Uncontrolled hemorrhagic shock animals (n = 10/group) underwent laparotomy, grade V liver injury, and blinded resuscitation with LR or NS to maintain baseline blood pressure for 1.5 h before sacrifice. Lung was harvested, and tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-α) were determined using quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). Sections of lung were processed and examined for neutrophils sequestered within the alveolar walls. Cytokine analysis showed no difference in IL-6 gene transcription in any group (P = 0.99). Resuscitated swine had elevated G-CSF and TNF-α gene transcription, but LR and NS groups were not different from each other (P = 0.96 and 0.10, respectively). Both resuscitation groups had significantly more alveolar neutrophils present than controls (P <0.01) and shams (P <0.05) but were not different from one another (P = 0.83). LR and NS resuscitation have equivalent effects on indices of inflammation in the lungs in our model of uncontrolled hemorrhagic shock.",
    keywords = "Cytokines, G-CSF, IL-6, Neutrophils, Normal saline, TNF-α",
    author = "Jennifer Watters and Brundage, {Susan I.} and Todd, {S. Rob} and Zautke, {Nathan A.} and Stefater, {J. A.} and Lam, {J. C.} and Muller, {Patrick J.} and Darren Malinoski and Martin Schreiber",
    year = "2004",
    month = "9",
    doi = "10.1097/01.shk.0000135288.54535.8a",
    language = "English (US)",
    volume = "22",
    pages = "283--287",
    journal = "Shock",
    issn = "1073-2322",
    publisher = "Lippincott Williams and Wilkins",
    number = "3",

    }

    TY - JOUR

    T1 - Resuscitation with lactated Ringer's does not increase inflammatory response in a swine model of uncontrolled hemorrhagic shock

    AU - Watters, Jennifer

    AU - Brundage, Susan I.

    AU - Todd, S. Rob

    AU - Zautke, Nathan A.

    AU - Stefater, J. A.

    AU - Lam, J. C.

    AU - Muller, Patrick J.

    AU - Malinoski, Darren

    AU - Schreiber, Martin

    PY - 2004/9

    Y1 - 2004/9

    N2 - Lactated Ringer's (LR) and normal saline (NS) are widely and interchangeably used for resuscitation of trauma victims. Studies show LR to be superior to NS in the physiologic response to resuscitation. Recent in vitro studies demonstrate equivalent effects of LR and NS on leukocytes. We aimed to determine whether LR resuscitation would produce an equivalent inflammatory response compared with normal saline (NS) resuscitation in a clinically relevant swine model of uncontrolled hemorrhagic shock. Thirty-two swine were randomized. Control animals (n = 6) were sacrificed following induction of anesthesia for baseline data. Sham animals (n = 6) underwent laparotomy and 2 h of anesthesia. Uncontrolled hemorrhagic shock animals (n = 10/group) underwent laparotomy, grade V liver injury, and blinded resuscitation with LR or NS to maintain baseline blood pressure for 1.5 h before sacrifice. Lung was harvested, and tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-α) were determined using quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). Sections of lung were processed and examined for neutrophils sequestered within the alveolar walls. Cytokine analysis showed no difference in IL-6 gene transcription in any group (P = 0.99). Resuscitated swine had elevated G-CSF and TNF-α gene transcription, but LR and NS groups were not different from each other (P = 0.96 and 0.10, respectively). Both resuscitation groups had significantly more alveolar neutrophils present than controls (P <0.01) and shams (P <0.05) but were not different from one another (P = 0.83). LR and NS resuscitation have equivalent effects on indices of inflammation in the lungs in our model of uncontrolled hemorrhagic shock.

    AB - Lactated Ringer's (LR) and normal saline (NS) are widely and interchangeably used for resuscitation of trauma victims. Studies show LR to be superior to NS in the physiologic response to resuscitation. Recent in vitro studies demonstrate equivalent effects of LR and NS on leukocytes. We aimed to determine whether LR resuscitation would produce an equivalent inflammatory response compared with normal saline (NS) resuscitation in a clinically relevant swine model of uncontrolled hemorrhagic shock. Thirty-two swine were randomized. Control animals (n = 6) were sacrificed following induction of anesthesia for baseline data. Sham animals (n = 6) underwent laparotomy and 2 h of anesthesia. Uncontrolled hemorrhagic shock animals (n = 10/group) underwent laparotomy, grade V liver injury, and blinded resuscitation with LR or NS to maintain baseline blood pressure for 1.5 h before sacrifice. Lung was harvested, and tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-α) were determined using quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). Sections of lung were processed and examined for neutrophils sequestered within the alveolar walls. Cytokine analysis showed no difference in IL-6 gene transcription in any group (P = 0.99). Resuscitated swine had elevated G-CSF and TNF-α gene transcription, but LR and NS groups were not different from each other (P = 0.96 and 0.10, respectively). Both resuscitation groups had significantly more alveolar neutrophils present than controls (P <0.01) and shams (P <0.05) but were not different from one another (P = 0.83). LR and NS resuscitation have equivalent effects on indices of inflammation in the lungs in our model of uncontrolled hemorrhagic shock.

    KW - Cytokines

    KW - G-CSF

    KW - IL-6

    KW - Neutrophils

    KW - Normal saline

    KW - TNF-α

    UR - http://www.scopus.com/inward/record.url?scp=7944238687&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=7944238687&partnerID=8YFLogxK

    U2 - 10.1097/01.shk.0000135288.54535.8a

    DO - 10.1097/01.shk.0000135288.54535.8a

    M3 - Article

    C2 - 15316400

    AN - SCOPUS:7944238687

    VL - 22

    SP - 283

    EP - 287

    JO - Shock

    JF - Shock

    SN - 1073-2322

    IS - 3

    ER -