Advanced search
Start date
Betweenand
Related content
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Protection of cerebral microcirculation, mitochondrial function, and electrocortical activity by small-volume resuscitation with terlipressin in a rat model of haemorrhagic shock

Full text
Author(s):
Ida, K. K. [1, 2] ; Chisholm, K. I. [1] ; Malbouisson, L. M. S. [2] ; Papkovsky, D. B. [3] ; Dyson, A. [4] ; Singer, M. [4] ; Duchen, M. R. [5] ; Smith, K. J. [1]
Total Authors: 8
Affiliation:
[1] UCL, Inst Neurol, Queen Sq, London - England
[2] Univ Sao Paulo, Sch Med, Postgrad Program Anaesthesiol, Lab Med Invest 8, Sao Paulo - Brazil
[3] Univ Coll Cork, Sch Biochem & Cell Biol, Cork - Ireland
[4] UCL, Bloomsbury Inst Intens Care Med, London - England
[5] UCL, Cell & Dev Biol, London - England
Total Affiliations: 5
Document type: Journal article
Source: BRITISH JOURNAL OF ANAESTHESIA; v. 120, n. 6, p. 1245-1254, JUN 2018.
Web of Science Citations: 2
Abstract

Background: During early treatment of haemorrhagic shock, cerebral perfusion pressure can be restored by small-volume resuscitation with vasopressors. Whether this therapy is improved with additional fluid remains unknown. We assessed the value of terlipressin and lactated Ringer's solution (LR) on early recovery of microcirculation, tissue oxygenation, and mitochondrial and electrophysiological function in the rat cerebral cortex. Methods: Animals treated with LR replacing three times (3LR) the volume bled (n = 26), terlipressin (n = 27), terlipressin plus 1LR (n = 26), 2LR (n = 16), or 3LR (n = 15) were compared with untreated (n = 36) and sham-operated rats (n = 17). In vivo confocal microscopy was used to assess cortical capillary perfusion, changes in tissue oxygen concentration, and mitochondrial membrane potential and redox state. Electrophysiological function was assessed by cortical somatosensory evoked potentials, spinal cord dorsum potential, and peripheral electromyography. Results: Compared with sham treatment, haemorrhagic shock reduced the mean (SD) area of perfused vessels {[}82% (SD 10%) vs 38% (12%); P<0.001] and impaired oxygen concentration, mitochondrial redox state {[}99% (4%) vs 59% (15%) of baseline; P<0.001], and somatosensory evoked potentials {[}97%(13%) vs 27%(19%) of baseline]. Administration of terlipressin plus 1LR or 2LR was able to recover these measures, but terlipressin plus 3LR or 3LR alone were not as effective. Spinal cord dorsum potential was preserved in all groups, but no therapy protected electromyographic function. Conclusions: Resuscitation from haemorrhagic shock using terlipressin with small-volume LR was superior to high-volume LR, with regard to cerebral microcirculation, and mitochondrial and electrophysiological functions. (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 Opportunities: Scholarships in Brazil - Doctorate