Comparison of resuscitation effects of Ringer lactate, hypertonic saline solution and terlipressin oncoagulation profile in a experimental model of hemorrhagic shock

• Grant number: 11/23845-0
• Support type: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): April 01, 2012
• Effective date (End): March 31, 2013
• Field of knowledge: Health Sciences - Medicine
• Principal researcher: Luiz Marcelo Sá Malbouisson
• Grantee: Adolfo Toshiro Cotarelli Sasaki
• Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

The therapeutic strategies used for resuscitation of hemorrhagic shock (HS) during pre-hospital care are capable of preventing death from circulatory collapse. However, besides the hemodynamic restoration, it is essential that this therapy also produces minimal hemostatic disturbances for an appropriate control of bleeding. Therefore, the objective of this study is to compare the effects of resuscitation with Ringer lactate (RL), hypertonic saline solution (HSS) and terlipressin (TLP) on the coagulation profile in an experimental model of HS. For this purpose, HS will be induced in 40 pigs of 20-30 kg by means of bleeding for 20 minutes to achieve a mean arterial pressure (MAP) of 40 mmHg, and maintenance of this MAP during the following 30 minutes. Animals will be randomized into four groups of 10 animals each, which will be considered Control Group and groups treated for HS: RL Group, HSS Group and TLP Group. The platelet count; concentration of fibrinogen, factor V and D-dimer; measure of prothrombin time, activated partial thromboplastin time and thrombin time (TT) will be evaluated prior HS (baseline), immediately after HS establishment, and after 30 and 120 minutes of the treatment. At the end of the study, animals will be euthanized according to standard rules of animal use in laboratory research. Data will be subjected to analysis of variance for repeated measures followed by Tukey test and t-Student test. Differences will be considered significant when p<0.05.

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

IDA, KEILA KAZUE; OTSUKI, DENISE AYA; COTARELLI SASAKI, ADOLFO TOSHIRO; BORGES, EMILYN SILVA; CARDOSO CASTRO, LETCIA URBANO; SANCHES, TALITA ROJAS; SHIMIZU, MARIA-HELOISA MASSOLA; ANDRADE, LCIA CONCEICAO; AULER, JR., JOSE-OTAVIO COSTA; DYSON, ALEX; SMITH, KENNETH JOHN; ROCHA FILHO, JOEL AVANCINI; MALBOUISSON, LUIZ-MARCELO SA. Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock. Critical Care, v. 19, MAR 13 2015. Web of Science Citations: 5.