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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

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

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Autor(es):
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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]
Número total de Autores: 13
Afiliação do(s) autor(es):
[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
Número total de Afiliações: 5
Tipo de documento: Artigo Científico
Fonte: Critical Care; v. 19, MAR 13 2015.
Citações Web of Science: 5
Resumo

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)

Processo FAPESP: 11/23845-0 - Comparação dos efeitos da ressuscitação com Ringer Lactato, solução salina hipertônica e terlipressina sobre o perfil de coagulação em modelo experimental de choque hemorrágico
Beneficiário:Adolfo Toshiro Cotarelli Sasaki
Linha de fomento: Bolsas no Brasil - Iniciação Científica
Processo FAPESP: 11/00348-1 - Comparação dos efeitos da ressuscitação com Ringer lactato, solução salina hipertônica e terlipressina sobre a perfusão e oxigenação cerebral em modelo experimental de choque hemorrágico
Beneficiário:Luiz Marcelo Sá Malbouisson
Linha de fomento: Auxílio à Pesquisa - Regular
Processo FAPESP: 11/14386-2 - Comparação dos efeitos da ressuscitação com Ringer Lactato, solução salina hipertônica e terlipressina sobre a perfusão e oxigenação cerebral em modelo experimental de choque hemorrágico
Beneficiário:Keila Kazue Ida
Linha de fomento: Bolsas no Brasil - Doutorado
Processo FAPESP: 12/04128-9 - Comparação dos efeitos da ressuscitação com Ringer Lactato, solução salina hipertônica e terlipressina sobre a função renal em modelo experimental de choque hemorrágico
Beneficiário:Leticia Urbano Cardoso de Castro
Linha de fomento: Bolsas no Brasil - Mestrado