The renal effect of replacement fluids in controlled severe hemorrhagic shock: an experimental study

Ulus Travma Acil Cerrahi Derg. 2009 Sep;15(5):423-32.

Abstract

Background: This experimental study examined the effects of resuscitation with Ringer's lactate (RL), 6% hydroxyethyl starch (130/0.4-HES), and the combination of RL and HES on renal function in hemorrhagic shock (HS).

Methods: Twenty-four male New Zealand white rabbits weighing 2198-3435 g were divided at random into four groups. HS was constituted by maintaining the mean arterial blood pressure at 30 mmHg and blood lactate at >4 mM/L. Subsequently, Group 1 (control) was not resuscitated, while the study rabbits' resuscitation was initiated with RL (Group 2), HES (Group 3), or the combination of RL and HES (Group 4).

Results: In all groups, the serum creatinine and blood urea nitrogen (BUN) levels were observed to be within normal limits, while the lactate dehydrogenase and alpha-1 microglobulin levels statistically significantly increased when time points were compared with beginning values (p<0.05). Furthermore, cystatin-C levels were observed to be increased after the HS (p<0.05), but returned to the normal level after resuscitation in all the study groups. Interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha levels were increased in all the rabbits after HS (p<0.05), and there were no significant differences among the study groups after resuscitation (p>0.05). There were no differences in the histological imaging between the groups (p>0.05).

Conclusion: The 6% HES (130/0.4) did not have any harmful effects on the kidney when it was used alone or in combination with crystalloid for resuscitation of HS in rabbits.

MeSH terms

  • Animals
  • Blood Urea Nitrogen
  • Creatinine / blood
  • Disease Models, Animal
  • Fluid Therapy / methods*
  • Hydroxyethyl Starch Derivatives / pharmacology*
  • Isotonic Solutions / pharmacology*
  • Kidney / drug effects*
  • Kidney / physiology
  • Male
  • Plasma Substitutes / pharmacology*
  • Protective Agents
  • Rabbits
  • Random Allocation
  • Resuscitation / methods
  • Ringer's Lactate
  • Shock, Hemorrhagic / complications
  • Shock, Hemorrhagic / therapy*

Substances

  • Hydroxyethyl Starch Derivatives
  • Isotonic Solutions
  • Plasma Substitutes
  • Protective Agents
  • Ringer's Lactate
  • Creatinine