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Remmers DE, Wang P, Cioffi WG, et al. Chronic resuscitation after trauma-hemorrhage and acute fluid replacement improves hepatocellular function and cardiac output. Ann Surg. 1998;227(1):112-9doi: 10.1097/00000658-199801000-00016.
Remmers, D. E., Wang, P., Cioffi, W. G., Bland, K. I., & Chaudry, I. H. (1998). Chronic resuscitation after trauma-hemorrhage and acute fluid replacement improves hepatocellular function and cardiac output. Annals of surgery, 227(1), 112-9. https://doi.org/10.1097/00000658-199801000-00016
Remmers, D E, et al. "Chronic resuscitation after trauma-hemorrhage and acute fluid replacement improves hepatocellular function and cardiac output." Annals of surgery vol. 227,1 (1998): 112-9. doi: https://doi.org/10.1097/00000658-199801000-00016
Remmers DE, Wang P, Cioffi WG, Bland KI, Chaudry IH. Chronic resuscitation after trauma-hemorrhage and acute fluid replacement improves hepatocellular function and cardiac output. Ann Surg. 1998 Jan;227(1):112-9. doi: 10.1097/00000658-199801000-00016. PMID: 9445118; PMCID: PMC1191180.
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Wolters Kluwer Free PMC Article

Ann Surg. 1998 Jan;227(1):112-9. doi: 10.1097/00000658-199801000-00016.

Chronic resuscitation after trauma-hemorrhage and acute fluid replacement improves hepatocellular function and cardiac output.

Annals of surgery

D E Remmers, P Wang, W G Cioffi, K I Bland, I H Chaudry

Affiliations

  1. Center for Surgical Research, Brown University School of Medicine and Rhode Island Hospital, Providence 02903, USA.

PMID: 9445118 PMCID: PMC1191180 DOI: 10.1097/00000658-199801000-00016
Free PMC Article

Abstract

OBJECTIVE: To determine whether prolonged (chronic) resuscitation has any beneficial effects on cardiac output and hepatocellular function after trauma-hemorrhage and acute fluid replacement.

BACKGROUND DATA: Acute fluid resuscitation after trauma-hemorrhage restores but does not maintain the depressed hepatocellular function and cardiac output.

METHODS: Male Sprague-Dawley rats underwent a 5-cm laparotomy (i.e., trauma was induced) and were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of maximal bleed-out volume was returned in the form of Ringer's lactate (RL). The animals were acutely resuscitated with RL using 4 times the volume of maximum bleed-out over 60 minutes, followed by chronic resuscitation of 0, 5, or 10 mL/kg/hr RL for 20 hours. Hepatocellular function was determined by an in vivo indocyanine green clearance technique. Hepatic microvascular blood flow was assessed by laser Doppler flowmetry. Plasma levels of interleukin-6 (IL-6) were determined by bioassay.

RESULTS: Chronic resuscitation with 5 mL/kg/hr RL, but not with 0 or 10 mL/kg/hr RL, restored cardiac output, hepatocellular function, and hepatic microvascular blood flow at 20 hours after hemorrhage. The regimen above also reduced plasma IL-6 levels.

CONCLUSION: Because chronic resuscitation with 5 mL/kg/hr RL after trauma-hemorrhage and acute fluid replacement restored hepatocellular function and hepatic microvascular blood flow and decreased plasma levels of IL-6, we propose that chronic fluid resuscitation in addition to acute fluid replacement should be routinely used in experimental studies of trauma-hemorrhage.

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