Effects of terlipressin in a rat model of severe uncontrolled hemorrhage via liver injury

Am J Emerg Med. 2012 Sep;30(7):1176-82. doi: 10.1016/j.ajem.2011.09.007. Epub 2011 Nov 17.

Abstract

Background: Animal experiments and clinical studies have shown that vasopressin infusion in cases of uncontrolled hemorrhagic shock is a promising treatment. However, there are only a few studies regarding the application of terlipressin in hemorrhagic cases. This study was designed to evaluate the effects of terlipressin vs controlled fluid resuscitation on hemodynamic variables and abdominal bleeding in a rat model of uncontrolled hemorrhage via liver injury.

Methods: A total of 21 average weight 250 ± 30 g Wistar rats were used. A midline celiotomy was performed, and approximately 65% of the median and left lateral lobes were removed with sharp dissection. After creation of the liver injury, rats were randomized into 1 of 3 resuscitation groups, the control group, Lactated Ringer's (LR) group, and terlipressin group, with 7 rats in each group. Blood samples were taken from rats for arterial blood gas analysis. At the end of the experiments, free intraperitoneal blood was collected on preweighed pieces of cotton, and the amount of free blood was determined by the difference in wet and dry weights.

Results: In response to resuscitation, the terlipressin group demonstrated a significant elevation in mean arterial pressure (MAP). Blood loss was greater in the LR group compared with the control group (12.8 ± 1.9 mL vs 8.2 ± 0.7 mL, P < .05). At the end of the experiments, 5 rats in the control group, 5 in the LR group, and 2 in the terlipressin group died. The average survival rates were 28.6%, 28.6%, and 71.4%, respectively.

Conclusions: Compared with the control group, intravenous terlipressin bolus after liver injury contributed to an increase in MAP and survival rates without increasing abdominal bleeding.

MeSH terms

  • Animals
  • Blood Pressure / drug effects
  • Disease Models, Animal
  • Hemorrhage / drug therapy*
  • Hemorrhage / etiology
  • Liver / injuries*
  • Lypressin / analogs & derivatives*
  • Lypressin / therapeutic use
  • Male
  • Rats
  • Rats, Wistar
  • Resuscitation / methods
  • Terlipressin
  • Vasoconstrictor Agents / therapeutic use*

Substances

  • Vasoconstrictor Agents
  • Lypressin
  • Terlipressin