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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock

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Author(s):
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Ida, Keila Kazue [1, 2] ; Otsuki, Denise Aya [2] ; Cotarelli Sasaki, Adolfo Toshiro [2] ; Borges, Emilyn Silva [2] ; Cardoso Castro, Letcia Urbano [3] ; Sanches, Talita Rojas [3] ; Shimizu, Maria-Heloisa Massola [3] ; Andrade, Lcia Conceicao [3] ; Auler, Jr., Jose-Otavio Costa [2] ; Dyson, Alex [4] ; Smith, Kenneth John [1] ; Rocha Filho, Joel Avancini [5] ; Malbouisson, Luiz-Marcelo Sa [2]
Total Authors: 13
Affiliation:
[1] UCL, Inst Neurol, Dept Neuroinflammat, London WC1N 1PJ - England
[2] Univ Sao Paulo, Disciplina Anestesiol, Fac Med, Lab Invest Med LIM 08, BR-01246903 Sao Paulo - Brazil
[3] Univ Sao Paulo, Fac Med, Disciplina Nefrol, LIM HC FMUSP 12, BR-01246903 Sao Paulo - Brazil
[4] UCL, Div Med, London WC1E 6BT - England
[5] Univ Sao Paulo, HCFMUSP, Fac Med, Div Anestesiol, Hosp Clin, BR-05403000 Sao Paulo - Brazil
Total Affiliations: 5
Document type: Journal article
Source: Critical Care; v. 19, MAR 13 2015.
Web of Science Citations: 5
Abstract

Introduction: We investigated whether treatment with terlipressin during recovery from hypotension due to haemorrhagic shock (HS) is effective in restoring cerebral perfusion pressure (CPP) and brain tissue markers of water balance, oxidative stress and apoptosis. Methods: In this randomised controlled study, animals undergoing HS (target mean arterial pressure (MAP) 40 mmHg for 30 minutes) were randomised to receive lactated Ringer's solution (LR group; n = 14; volume equal to three times the volume bled), terlipressin (TERLI group; n = 14; 2-mg bolus), no treatment (HAEMO group; n = 12) or sham (n = 6). CPP, systemic haemodynamics (thermodilution technique) and blood gas analyses were registered at baseline, shock and 5, 30, 60 (T60), 90 and 120 minutes after treatment (T120). After the animals were killed, brain tissue samples were obtained to measure markers of water balance (aquaporin-4 (AQP4)), Na+-K+-2Cl(-) co-transporter (NKCC1)), oxidative stress (thiobarbituric acid reactive substances (TBARS) and manganese superoxide dismutase (MnSOD)) and apoptotic damage (Bcl-x and Bax). Results: Despite the HS-induced decrease in cardiac output (CO) and hyperlactataemia, resuscitation with terlipressin recovered MAP and resulted in restoration of CPP and in cerebral protection expressed by normalisation of AQP4, NKCC1, TBARS and MnSOD expression and Bcl-x/Bax ratio at T60 and T120 compared with sham animals. In the LR group, CO and blood lactate levels were recovered, but the CPP and MAP were significantly decreased and TBARS levels and AQP4, NKCC1 and MnSOD expression and Bcl-x/Bax ratio were significantly increased at T60 and T120 compared with the sham group. Conclusions: During recovery from HS-induced hypotension, terlipressin was effective in normalising CPP and cerebral markers of water balance, oxidative damage and apoptosis. The role of this pressor agent on brain perfusion in HS requires further investigation. (AU)

FAPESP's process: 11/14386-2 - Comparison of resuscitation effects of Ringer lactate, hypertonic saline solution and terlipressin on cerebral perfusion and oxygenation in an experimental model of hemorrhagic shock
Grantee:Keila Kazue Ida
Support type: Scholarships in Brazil - Doctorate
FAPESP's process: 12/04128-9 - Comparison of resuscitation effects of Ringer lactate, hypertonic saline solution and terlipressin on renal function in an experimental model of hemorrhagic shock
Grantee:Leticia Urbano Cardoso de Castro
Support type: Scholarships in Brazil - Master
FAPESP's process: 11/00348-1 - Comparison of resuscitation effects of Ringer lactate, hypertonic saline solution and terlipressin on cerebral perfusion and oxygenation in an experimental model of hemorrhagic shock
Grantee:Luiz Marcelo Sá Malbouisson
Support type: Regular Research Grants
FAPESP's process: 11/23845-0 - Comparison of resuscitation effects of Ringer lactate, hypertonic saline solution and terlipressin oncoagulation profile in a experimental model of hemorrhagic shock
Grantee:Adolfo Toshiro Cotarelli Sasaki
Support type: Scholarships in Brazil - Scientific Initiation