Hypothermia caused by slow and limited-volume fluid resuscitation decreases organ damage by hemorrhagic shock

BackgroundHypothermia frequently occurs during fluid resuscitation of trauma victims, especially in patients with a major blood loss. Recent studies have suggested that mild hypothermia may ameliorate hemorrhagic shock (HS) induced splanchnic damage.ObjectiveThe aim of the present study is to compare the status of body temperature and splanchnic injury under different resuscitation speeds for HS in conscious rats.MethodsExperimental study in an animal model of HS. Twenty-four male Wistar-Kyoto rats were used in the study. To mimic HS, 40% of the total blood volume was withdrawn. Fluid resuscitation was given 30 min after blood withdrawal. The rats were randomly divided into three groups; the control group, the 10-min rapid group, and the 12-h slow group.ResultsLevels of blood biochemical parameters, including aspartate transferase (GOT), and alanine transferase (GPT), were measured. Levels of serum tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) were measured and levels of bronchoalveolar lavage fluid (BALF) TNF-α and nitric oxide (NO) were measured by ELISA. The lung, liver and small intestine were examined for pathological changes 48 h after HS.ConclusionsInitially slow rate resuscitation with limited-volume significantly decreased body temperature, serum GOT, GPT, TNF-α, and IL-6 levels, levels of TNF-α, and NO in BALF. Moreover, the slow group had lower injury scores in the lung, liver and small intestine than the rapid group after HS. This finding suggests that mild hypothermia induced by a slow fluid resuscitation rate with limited-volume ameliorates HS-induced splanchnic damage in conscious rats.

► Mild hypothermia may ameliorate hemorrhagic shock (HS) induced splanchnic damage. ► Adequate fluid resuscitation is a common treatment modality for traumatic HS. ► Mild hypothermia was induced by slow and limited-volume resuscitation. ► Slow and limited-volume resuscitation fluid ameliorates HS-induced splanchnic damage.