The Characteristics of Organ Function Damage of Hemorrhagic Shock in Hot Environment and The Effect of Hypothermic Fluid Resuscitation

Shock ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yu Zhu ◽  
Sheng Ma ◽  
Hao-Yue Deng ◽  
Yue Wu ◽  
Jie Zhang ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Fluid Resuscitation ◽  
Organ Function ◽  
Hot Environment

scholarly journals Hot environment aggravated hemorrhagic shock-induced organ dysfunction and protective effects of cold fluid resuscitation

2021 ◽  
Author(s):  
Yu Zhu ◽  
Sheng Ma ◽  
Haoyue Deng ◽  
Han She ◽  
Jie Zhang ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Organ Dysfunction ◽  
Fluid Resuscitation ◽  
Stress Factors ◽  
Inflammatory Factors ◽  
Targeted Prevention ◽  
Pathophysiological Mechanism ◽  
Protective Effects ◽  
Internal Environment ◽  
Hot Environment

Abstract Background There are more and more areas with hot environment. Whether hot environment can aggravate hemorrhagic shock-induced organ dysfunction and its pathophysiological mechanism and treatment remains unclear. Methods Hemorrhagic shock rat model in hot environment was used to observe the changes of vital organ functions, the variation of the internal environment, stress factors and inflammatory factors, meanwhile, the targeted prevention and treatment measures were further studied. Results Hot environment further aggravated hemorrhagic shock induced death even in 34℃ hot environment which core temperature was not increased. At the same time, functions of heart, liver and kidney were more damaged after hemorrhagic shock rats in 34℃ hot environment as compared with room environment. The further study showed that the blood concentration of Na+, K+ and plasma osmotic pressure, the expression of inflammatory factors tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the serum, as well as the stress factors Adrenocorticotropic Hormone (ACTH) and Glucocorticoid (GCS) were all notably enhanced following hot environment with hemorrhagic shock; and acidosis was extraordinary obvious; oxygen supply and oxygen consumption were remarkably decreased. At last present study demonstrated that 4–10℃ hypothermia fluid resuscitation could significantly improve the survival rate in hemorrhagic shock rats with hot environment. Conclusions Hot environment accelerated the death of hemorrhagic shock rats, which was related to the disorder of internal environment, increase of inflammatory and stress factors. Furthermore, moderate hypothermic fluid resuscitation was suitable for the treatment of hemorrhagic shock in hot environment.

scholarly journals Electroacupuncture Improves the Survival Rate and Organ Function in a Rat Model of Hemorrhagic Shock

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Yuxian Zhong ◽  
Guochen Xu ◽  
Yushou Wu ◽  
Huiping Zhang ◽  
Haibin Wang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Survival Rate ◽  
Hemorrhagic Shock ◽  
Fluid Resuscitation ◽  
Diamine Oxidase ◽  
Mucosal Blood Flow ◽  
Tissue Perfusion ◽  
Organ Function ◽  
Organ Protection ◽  
Arterial Blood

Electroacupuncture (EA) at ST36 can improve the survival rate in rats after hemorrhagic shock (HS). The current study investigated rats with 60% blood loss. 144 rats were divided into four groups: hemorrhage without fluid resuscitation (HS), EA after hemorrhage without fluid resuscitation (EA), hemorrhage with delayed resuscitation (DFR), and EA after hemorrhage with delayed resuscitation (EA + DFR). The survival rate and biological parameters 0, 3, 12, and 24 h after HS were investigated. The 24 h survival rate of EA + DFR was significantly higher than that of DFR. 12 h after hemorrhage, the level of mean arterial blood pressure of EA + DFR was significantly higher than that of DFR, and the levels of renal blood flow, intestinal mucosal blood flow, and hepatic blood flow of EA + DFR were also significantly higher than those of DFR. Three hours after hemorrhage, the levels of lactate, PaCO2, alanine aminotransferase, and creatinine of groups receiving EA were significantly lower than those of non-EA groups, and the levels of pH, PaO2, and diamine oxidase of groups receiving EA were significantly higher. EA at ST36 can improve the 24 h survival rate and produce the experimental antishock effects on tissue perfusion and organ protection from fatal HS.

P68 Self-resuscitation and limited fluid resuscitation (FR) for severe “prehospital” hemorrhagic shock (HS) in rats

Resuscitation ◽  
1994 ◽  
Vol 28 (2) ◽  
pp. S13
Author(s):  
A. Capone ◽  
P. Safar ◽  
D. Crippen ◽  
Y. Leonov ◽  
S. Tisherman ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Fluid Resuscitation

scholarly journals Is restrictive fluid resuscitation beneficial not only for hemorrhagic shock but also for septic shock?

Medicine ◽  
2021 ◽  
Vol 100 (12) ◽  
pp. e25143
Author(s):  
Shuaiyu Jiang ◽  
Mengmeng Wu ◽  
Xiaoguang Lu ◽  
Yilong Zhong ◽  
Xin Kang ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hemorrhagic Shock ◽  
Fluid Resuscitation

Abstract 16745: It Would be Possible to Rescue Traumatic Hemorrhagic Shock Patients Who Failed to Fluid Resuscitation (Fluid Non-responder) but Succeed in REBOA Resuscitation (REBOA/IABO Responder)

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Tomohiko Orita ◽  
Tomohiro Funabiki ◽  
Motoyasu Yamazaki ◽  
Masayuki Shimizu ◽  
Tomohiro Sato ◽  
...  
Keyword(s):  
Survival Rate ◽  
Hemorrhagic Shock ◽  
Fluid Resuscitation ◽  
Recovery Rate ◽  
Balloon Occlusion ◽  
Shock State ◽  
Occlusion Time ◽  
Aortic Balloon Occlusion ◽  
Significant Difference ◽  
Traumatic Hemorrhagic Shock

Introduction: Fluid resuscitation (FR) and massive transfusion protocol (MTP) are important initial strategies for traumatic hemorrhagic shock cases. But poor responded patients to them are difficult to rescue. In such cases, open aortic cross clamping or intra-aortic balloon occlusion (IABO) would be performed as a temporary hemostasis treatment. Recently, IABO for severe trauma has been named resuscitative endovascular balloon occlusion of the aorta (REBOA). But it is still unclear which case can be rescued with REBOA. So we studied the relationship between the responsiveness to FR and REBOA. Methods: Consecutive 46 traumatic hemorrhagic shock patients underwent REBOA at our ER for last 86 months were included. All of their FAST were positive and done FR and MTP as a first-line resuscitation. 10Fr or 7Fr IABO devices were inserted at supraphrenic level (zone I) and underwent fundamental hemostasis by operative management (OM) and/or transcatheter arterial embolization (TAE). They were sorted into responded group or non-responded group for REBOA. The primary end point was a recovery rate from the shock state within 48 hours. Secondary end points were a survival rate in 30th days and a rate of complications. Results: 26 transient or non-responded patients (Fluid Non-responder) responded for REBOA (REBOA Responder group). 20 Fluid Non-responders did not respond for REBOA (REBOA Non-responder group). There were no significant differences in ISS (REBOA Responder vs. Non-responder: 45.8+/-15.2 vs. 54.8+/-22.3), amount of total fluid (7187+/-5782ml vs. 6772+/-4851) and total blood transfusion (4816+/-3006ml vs. 5080+/-3330), required time to occlude after arriving ER (25.3+/-12.6min vs. 19.4+/-9.8) and total occlusion time (76.4+/-66.5min vs. 92.7+/-34.4). There was significant difference in the changes of systolic blood pressure before and after of REBOA (59.3+/-25.7mmHg vs. 38.3+/-39.4, p=0.04). A recovery rate from shock state was 65%(12/26) vs. 0%(0/20) (p<0.01) and a survival rate was 14/26(54%) vs. 0/20(0%) (p<0.01). One complication occurred in REBOA Responder group but was not lethal. Conclusions: It would be necessary to recognize that Fluid Non-responder but REBOA Responder with traumatic hemorrhagic shock could be possible to rescue.

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