Skip to main content
Top
Published in: Critical Care 5/2013

Open Access 01-10-2013 | Research

Ideal resuscitation pressure for uncontrolled hemorrhagic shock in different ages and sexes of rats

Authors: Tao Li, Yu Zhu, Kunlun Tian, Mingying Xue, Xiaoyong Peng, Dan Lan, Liangming Liu

Published in: Critical Care | Issue 5/2013

Login to get access

Abstract

Introduction

Our previous studies demonstrated that 50-60 mmHg mean arterial blood pressure was the ideal target hypotension for uncontrolled hemorrhagic shock during the active hemorrhage in sexually mature rats. The ideal target resuscitation pressure for immature and older rats has not been determined.

Methods

To elucidate this issue, using uncontrolled hemorrhagic-shock rats of different ages and sexes (6 weeks, 14 weeks and 1.5 years representing pre-adult, adult and older rats, respectively), the resuscitation effects of different target pressures (40, 50, 60, 70 and 80 mmHg) on uncontrolled hemorrhagic shock during active hemorrhage and the age and sex differences were observed.

Results

Different target resuscitation pressures had different resuscitation outcomes for the same age and sex of rats. The optimal target resuscitation pressures for 6-week-old, 14-week-old and 1.5-year-old rats were 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg respectively. Ideal target resuscitation pressures were significantly superior to other resuscitation pressures in improving the hemodynamics, blood perfusion, organ function and animal survival of uncontrolled hemorrhagic-shock rats (P < 0.01). For same target resuscitation pressures, the beneficial effect on hemorrhagic shock had a significant age difference (P < 0.01) but no sex difference (P > 0.05). Different resuscitation pressures had no effect on coagulation function.

Conclusion

Hemorrhagic-shock rats at different ages have different target resuscitation pressures during active hemorrhage. The ideal target resuscitation hypotension for 6-week-old, 14-week-old and 1.5-year-old rats was 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg, respectively. Their resuscitation effects have significant age difference but had no sex difference.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bellamy RF: The causes of death in conventional land warfare: Implications for combat casualty care research. Mil Med 1984, 149: 283-289. Bellamy RF: The causes of death in conventional land warfare: Implications for combat casualty care research. Mil Med 1984, 149: 283-289.
2.
go back to reference Stern SA, Dronen SC, Wang Z: Multiple resuscitation regimens in a near-fatal porcine aortic injury hemorrhage model. AcadEmerg Med 1995, 2: 89-97. Stern SA, Dronen SC, Wang Z: Multiple resuscitation regimens in a near-fatal porcine aortic injury hemorrhage model. AcadEmerg Med 1995, 2: 89-97.
3.
go back to reference Bickell WH, Matthew J, Wall MJ Jr, Pepe PE, Martin RR, Ginger VF, Allen MK, Mattox KL: Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994, 331: 1105-1109. 10.1056/NEJM199410273311701CrossRefPubMed Bickell WH, Matthew J, Wall MJ Jr, Pepe PE, Martin RR, Ginger VF, Allen MK, Mattox KL: Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994, 331: 1105-1109. 10.1056/NEJM199410273311701CrossRefPubMed
4.
go back to reference Stern SA, Dronen SC, Birrer P, Wang X: Effect of blood pressure on hemorrhage volume and survival in a near-fatal hemorrhage model incorporating a vascular injury. Ann Emerg Med 1993, 22: 155-163. 10.1016/S0196-0644(05)80195-7CrossRefPubMed Stern SA, Dronen SC, Birrer P, Wang X: Effect of blood pressure on hemorrhage volume and survival in a near-fatal hemorrhage model incorporating a vascular injury. Ann Emerg Med 1993, 22: 155-163. 10.1016/S0196-0644(05)80195-7CrossRefPubMed
5.
go back to reference Capone A, Safar P, Stezoki W, Tisherman S, Peitzman AB: Improved outcome with fluid restriction in treatment of uncontrolled hemorrhagic shock. J Am CollSurg 1995, 180: 49-56. Capone A, Safar P, Stezoki W, Tisherman S, Peitzman AB: Improved outcome with fluid restriction in treatment of uncontrolled hemorrhagic shock. J Am CollSurg 1995, 180: 49-56.
6.
go back to reference Kowalenko T, Stern S, Dronen S, Wang X: Improved outcome with hypotensive resuscitation of uncontrolled hemorrhagic shock in a swine model. J Trauma 1992, 33: 349-353. 10.1097/00005373-199209000-00003CrossRefPubMed Kowalenko T, Stern S, Dronen S, Wang X: Improved outcome with hypotensive resuscitation of uncontrolled hemorrhagic shock in a swine model. J Trauma 1992, 33: 349-353. 10.1097/00005373-199209000-00003CrossRefPubMed
7.
go back to reference Li T, Zhu Y, Hu Y, Liao ZF, Li P, Liu LM: Ideal permissive hypotension to resuscitate uncontrolled hemorrhagic shock and the tolerance time in rats. Anesthesiology 2011, 114: 111-119. 10.1097/ALN.0b013e3181fe3fe7CrossRefPubMed Li T, Zhu Y, Hu Y, Liao ZF, Li P, Liu LM: Ideal permissive hypotension to resuscitate uncontrolled hemorrhagic shock and the tolerance time in rats. Anesthesiology 2011, 114: 111-119. 10.1097/ALN.0b013e3181fe3fe7CrossRefPubMed
8.
go back to reference Li T, Zhu Y, Fang YQ, Liu LM: Determining the optimal mean arterial pressure for post-bleeding resuscitation in traumatized rats. Anesthesiology 2012, 116: 103-112. 10.1097/ALN.0b013e31823de24fCrossRefPubMed Li T, Zhu Y, Fang YQ, Liu LM: Determining the optimal mean arterial pressure for post-bleeding resuscitation in traumatized rats. Anesthesiology 2012, 116: 103-112. 10.1097/ALN.0b013e31823de24fCrossRefPubMed
9.
go back to reference Li T, Lin XL, Zhu Y, Liu LM: Short-term, mild hypothermia can increase the beneficial effect of permissive hypotension on uncontrolled hemorrhagic shock in rats. Anesthesiology 2012, 116: 1288-1298. 10.1097/ALN.0b013e318256f09dCrossRefPubMed Li T, Lin XL, Zhu Y, Liu LM: Short-term, mild hypothermia can increase the beneficial effect of permissive hypotension on uncontrolled hemorrhagic shock in rats. Anesthesiology 2012, 116: 1288-1298. 10.1097/ALN.0b013e318256f09dCrossRefPubMed
10.
go back to reference Almac E, Aksu U, Bezemer R, Jong W, Kandil A, Yuruk K, Demirci-Tansel C, Ince C: The acute effects of acetate-balanced colloid and crystalloid resuscitation on renal oxygenation in a rat model of hemorrhagic shock. J Trauma Acute Care Surg 2012, 72: 130-135. Almac E, Aksu U, Bezemer R, Jong W, Kandil A, Yuruk K, Demirci-Tansel C, Ince C: The acute effects of acetate-balanced colloid and crystalloid resuscitation on renal oxygenation in a rat model of hemorrhagic shock. J Trauma Acute Care Surg 2012, 72: 130-135.
11.
go back to reference Nishi K, Takasu A, Shibata M, Uchino S, Yamamoto Y, Sakamoto T: Hypothermia reduces resuscitation fluid volumes required to maintain blood pressure in a rat hemorrhagic shock model. Resuscitation 2012, 83: 1166-1172. 10.1016/j.resuscitation.2012.02.011CrossRef Nishi K, Takasu A, Shibata M, Uchino S, Yamamoto Y, Sakamoto T: Hypothermia reduces resuscitation fluid volumes required to maintain blood pressure in a rat hemorrhagic shock model. Resuscitation 2012, 83: 1166-1172. 10.1016/j.resuscitation.2012.02.011CrossRef
12.
go back to reference Dutton RP: Resuscitation. When less is more. Anesthesiology 2012, 116: 116-117. Dutton RP: Resuscitation. When less is more. Anesthesiology 2012, 116: 116-117.
13.
go back to reference Lloyd-Jones D, Adams RJ, Brown TM: Heart disease and stroke statistics - 2010 update: a report from the American Heart Association. Circulation 2010, 121: 46-215.CrossRef Lloyd-Jones D, Adams RJ, Brown TM: Heart disease and stroke statistics - 2010 update: a report from the American Heart Association. Circulation 2010, 121: 46-215.CrossRef
14.
go back to reference Sifri Z, Cohen D, Ananthakrishnan P, Wang L, Kaiser VL, Mohr AM, Hauser CJ, Rameshwar P, Deitch EA: Sex hormones affect bone marrow dysfunction after trauma and hemorrhagic shock. Crit Care Med 2007, 35: 864-869. 10.1097/01.CCM.0000256839.50053.1DCrossRefPubMed Sifri Z, Cohen D, Ananthakrishnan P, Wang L, Kaiser VL, Mohr AM, Hauser CJ, Rameshwar P, Deitch EA: Sex hormones affect bone marrow dysfunction after trauma and hemorrhagic shock. Crit Care Med 2007, 35: 864-869. 10.1097/01.CCM.0000256839.50053.1DCrossRefPubMed
15.
go back to reference Matsutani T, Kang SC, Miyashita M, Sasajima K, Choudhry MA, Bland KI, Chaudry IH: Young and middle-age associated differences in cytokeratin expression after bone fracture, tissue trauma, and hemorrhage. Am J Surg 2007, 193: 61-68. 10.1016/j.amjsurg.2006.07.012CrossRefPubMed Matsutani T, Kang SC, Miyashita M, Sasajima K, Choudhry MA, Bland KI, Chaudry IH: Young and middle-age associated differences in cytokeratin expression after bone fracture, tissue trauma, and hemorrhage. Am J Surg 2007, 193: 61-68. 10.1016/j.amjsurg.2006.07.012CrossRefPubMed
16.
go back to reference Murphy E: Estrogen signaling and cardiovascular disease. Circ Res 2011, 29: 687-695.CrossRef Murphy E: Estrogen signaling and cardiovascular disease. Circ Res 2011, 29: 687-695.CrossRef
17.
go back to reference Rossia R, France Y, Kingwellb BA, Ahimastosb AA: Gender differences in artery wall biomechanical properties throughout life. J Hypertens 2011, 29: 1023-1033. 10.1097/HJH.0b013e328344da5eCrossRef Rossia R, France Y, Kingwellb BA, Ahimastosb AA: Gender differences in artery wall biomechanical properties throughout life. J Hypertens 2011, 29: 1023-1033. 10.1097/HJH.0b013e328344da5eCrossRef
19.
go back to reference Bell C, Monahan KD, Hunt BE, Seals DR, Beck KC: Use of acetylene breathing to determine cardiac output in young and older adults. Med Sci Sports Exerc 2003, 35: 58-64. 10.1097/00005768-200301000-00010CrossRefPubMed Bell C, Monahan KD, Hunt BE, Seals DR, Beck KC: Use of acetylene breathing to determine cardiac output in young and older adults. Med Sci Sports Exerc 2003, 35: 58-64. 10.1097/00005768-200301000-00010CrossRefPubMed
20.
go back to reference Fleg JL, O'Connor F, Gerstenblith G, Becker LC, Clulow J, Schulman SP, Lakatta EG: Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. J ApplPhysiol 1995, 78: 890-900. Fleg JL, O'Connor F, Gerstenblith G, Becker LC, Clulow J, Schulman SP, Lakatta EG: Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. J ApplPhysiol 1995, 78: 890-900.
21.
go back to reference Hagberg JM, Allen WK, Seals DR, Hurley BF, Ehsani AA, Holloszy JO: A hemodynamic comparison of young and older endurance athletes during exercise. J ApplPhysiol 1985, 58: 2041-2046. Hagberg JM, Allen WK, Seals DR, Hurley BF, Ehsani AA, Holloszy JO: A hemodynamic comparison of young and older endurance athletes during exercise. J ApplPhysiol 1985, 58: 2041-2046.
22.
go back to reference Parker BA, Smithmyer SL, Pelberg JA, Mishkin AD, Proctor DN: Sex-specific influence of aging on exercising leg blood flow. J ApplPhysiol 2008, 104: 655-664. Parker BA, Smithmyer SL, Pelberg JA, Mishkin AD, Proctor DN: Sex-specific influence of aging on exercising leg blood flow. J ApplPhysiol 2008, 104: 655-664.
23.
go back to reference Beck KC, Proctor DN, Ridout SJ, Parker BA, Smithmyer SL, Gonzales JU: Age and sex influence the balance between maximal cardiac output and peripheral vascular reserve. J ApplPhysiol 2010, 108: 483-489. Beck KC, Proctor DN, Ridout SJ, Parker BA, Smithmyer SL, Gonzales JU: Age and sex influence the balance between maximal cardiac output and peripheral vascular reserve. J ApplPhysiol 2010, 108: 483-489.
24.
go back to reference Heinrich PC, Behrmann I, Muller-Newen G, Schaper F, Graeve L: Interleukin-6 type cytokine signalling through the gp130/Jak/STAT pathway. Biochem J 1998, 334: 297-314.PubMedCentralCrossRefPubMed Heinrich PC, Behrmann I, Muller-Newen G, Schaper F, Graeve L: Interleukin-6 type cytokine signalling through the gp130/Jak/STAT pathway. Biochem J 1998, 334: 297-314.PubMedCentralCrossRefPubMed
25.
go back to reference Linton PJ, Haynes L, Klinman NR, Swain SL: Antigen-independent changes in naive cells with aging. J Exp Med 1996, 184: 1891-900. 10.1084/jem.184.5.1891CrossRefPubMed Linton PJ, Haynes L, Klinman NR, Swain SL: Antigen-independent changes in naive cells with aging. J Exp Med 1996, 184: 1891-900. 10.1084/jem.184.5.1891CrossRefPubMed
26.
go back to reference Chen YM, Zhang JS, Duan XL: Changes of microvascular architecture, ultrastructure and permeability of rat jejunal villi at different ages. World J Gastroenterol 2003, 9: 795-799.PubMedCentralCrossRefPubMed Chen YM, Zhang JS, Duan XL: Changes of microvascular architecture, ultrastructure and permeability of rat jejunal villi at different ages. World J Gastroenterol 2003, 9: 795-799.PubMedCentralCrossRefPubMed
27.
go back to reference Korkushko OV, Sarkisov KG, Fraĭfel'd VE: Muscle blood flow in healthy persons of different ages. Med Radiol (Mosk) 1983, 28: 39-42. Korkushko OV, Sarkisov KG, Fraĭfel'd VE: Muscle blood flow in healthy persons of different ages. Med Radiol (Mosk) 1983, 28: 39-42.
28.
go back to reference Brohi K, Cohen MJ, Ganter MT, Schultz MJ, Levi M, Mackersie RC, Pittet JF: Acute coagulopathy of trauma: Hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma 2008, 64: 1211-1217. 10.1097/TA.0b013e318169cd3cCrossRefPubMed Brohi K, Cohen MJ, Ganter MT, Schultz MJ, Levi M, Mackersie RC, Pittet JF: Acute coagulopathy of trauma: Hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma 2008, 64: 1211-1217. 10.1097/TA.0b013e318169cd3cCrossRefPubMed
29.
go back to reference Hoyt DB, Dutton RP, Hauser CJ, Holcomb JB, Kluger Y, Mackway-Jones K, Parr MJ, Rizoli SB, Yukioka T, Bouillon B: Management of coagulopathy in the patients with multiple injuries: Results from an international survey of clinical practice. J Trauma 2008, 65: 755-764. 10.1097/TA.0b013e318185fa9fCrossRefPubMed Hoyt DB, Dutton RP, Hauser CJ, Holcomb JB, Kluger Y, Mackway-Jones K, Parr MJ, Rizoli SB, Yukioka T, Bouillon B: Management of coagulopathy in the patients with multiple injuries: Results from an international survey of clinical practice. J Trauma 2008, 65: 755-764. 10.1097/TA.0b013e318185fa9fCrossRefPubMed
30.
go back to reference Duchesne JC, Mathew KA, Marr AB, Pinsky MR, Barbeau JM, McSwain NE: Current evidence based guidelines for factor VIIa use in trauma: the good, the bad, and the ugly. Am Surg 2008, 74: 1159-1165.PubMed Duchesne JC, Mathew KA, Marr AB, Pinsky MR, Barbeau JM, McSwain NE: Current evidence based guidelines for factor VIIa use in trauma: the good, the bad, and the ugly. Am Surg 2008, 74: 1159-1165.PubMed
31.
go back to reference Maegele M, Lefering R, Paffrath T, Tjardes T, Simanski C, Bouillon B: Red blood cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiply injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft fur Unfallchirurgie. Vox Sang 2008, 95: 112-119. 10.1111/j.1423-0410.2008.01074.xCrossRefPubMed Maegele M, Lefering R, Paffrath T, Tjardes T, Simanski C, Bouillon B: Red blood cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiply injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft fur Unfallchirurgie. Vox Sang 2008, 95: 112-119. 10.1111/j.1423-0410.2008.01074.xCrossRefPubMed
32.
go back to reference Perkins JG, Cap AP, Spinella PC, Blackbourne LH, Wade CE, Holcomb JB: An evaluation of the impact of platelets used in the setting of massively transfused trauma patients. J Trauma 2009,66(Suppl 4):S77-S84. discussion S84-S85CrossRefPubMed Perkins JG, Cap AP, Spinella PC, Blackbourne LH, Wade CE, Holcomb JB: An evaluation of the impact of platelets used in the setting of massively transfused trauma patients. J Trauma 2009,66(Suppl 4):S77-S84. discussion S84-S85CrossRefPubMed
33.
go back to reference Martini WZ: Fibrinogen availability and coagulation function after hemorrhage and resuscitation in pigs. Mol Med 2011, 17: 757-761. 10.1007/s00894-010-0768-7PubMedCentralCrossRefPubMed Martini WZ: Fibrinogen availability and coagulation function after hemorrhage and resuscitation in pigs. Mol Med 2011, 17: 757-761. 10.1007/s00894-010-0768-7PubMedCentralCrossRefPubMed
Metadata
Title
Ideal resuscitation pressure for uncontrolled hemorrhagic shock in different ages and sexes of rats
Authors
Tao Li
Yu Zhu
Kunlun Tian
Mingying Xue
Xiaoyong Peng
Dan Lan
Liangming Liu
Publication date
01-10-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc12888

Other articles of this Issue 5/2013

Critical Care 5/2013 Go to the issue