Comparison of resuscitation effects of Ringer lactate, hypertonic saline solution and terlipressin on cerebral perfusion and oxygenation in an experimental model of hemorrhagic shock

• Grant number: 11/14386-2
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: October 01, 2013
• End date: June 30, 2015
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Luiz Marcelo Sá Malbouisson
• Grantee: Keila Kazue Ida
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Therapeutic strategies employed in the resuscitation of hemorrhagic shock (HS) during pre-hospital care are capable to avoid death from hemorrhage, but its side effects may exacerbate brain alterations induced by the circulatory collapse. Besides the hemodynamic recovery, it is essential that therapies for HS also restore cerebral variables, preventing the occurrence of neuronal injury and neurological sequelae. 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 cerebral perfusion and oxygenation in an experimental model of HS. For this purpose, HS will be induced in 40 pigs of 20-30 kg by means of volume-controlled bleeding, removing 50% of total blood volume in 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. Hemodynamic parameters and systemic oxygenation, cerebral perfusion and, oxygenation will be evaluated at baseline, immediately after HS, 20 minutes after HS, 30, 60, 90 and 120 minutes after 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, K. K.; CHISHOLM, K. I.; MALBOUISSON, L. M. S.; PAPKOVSKY, D. B.; DYSON, A.; SINGER, M.; DUCHEN, M. R.; SMITH, K. J.. Protection of cerebral microcirculation, mitochondrial function, and electrocortical activity by small-volume resuscitation with terlipressin in a rat model of haemorrhagic shock. BRITISH JOURNAL OF ANAESTHESIA, v. 120, n. 6, p. 1245-1254, JUN 2018. (11/14386-2)

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; et al. Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock. Critical Care, v. 19, MAR 13 2015. (11/14386-2, 11/23845-0, 12/04128-9, 11/00348-1)

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, JOSE-OTAVIO COSTA, JR.; DYSON, ALEX; et al. Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock. CRITICAL CARE, v. 19, p. 14-pg., 2015-03-13. (11/14386-2, 12/04128-9, 11/23845-0, 11/00348-1)

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

IDA, Keila Kazue. Comparison of the effects of lactated Ringer\'s solution, hypertonic saline solution and terlipressin resuscitation on cerebral tissue oxygenation and perfusion in an experimental model of haemorrhagic shock. 2015. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.