比较各种液体复苏策略对犬出血模型糖萼损伤的影响

IF 2.3 2区 农林科学 Q1 VETERINARY SCIENCES Veterinary journal Pub Date : 2024-08-08 DOI:10.1016/j.tvjl.2024.106221
Alan J. Weaver Jr. , Emilee C. Venn , Rebekah Ford , Nicole Ewer , Kim E. Hildreth , Charnae E. Williams , Christina E. Duncan , Cheresa L. Calhoun , Lonnie E. Grantham , Guillaume L. Hoareau , Thomas H. Edwards
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引用次数: 0

摘要

失血性休克和随后的复苏会导致包括血管内皮在内的关键系统严重失调。出血后,内皮衬里(糖萼)会脱落,导致糖萼成分释放、内皮活化和全身炎症。我们使用失血性休克犬模型来评估五种复苏液对糖萼脱落的影响,包括乳酸林格液+鲸蜡淀粉、全血(WB)、新鲜冰冻血浆+包装红细胞(FFP+pRBC)和两种基于血红蛋白的氧载体(HBOC)液。在麻醉状态下,对专门饲养的成年犬进行仪器操作,并进行控制性出血,抽血直至平均动脉压达到
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Comparing the effects of various fluid resuscitative strategies on Glycocalyx damage in a canine hemorrhage model

Hemorrhagic shock and subsequent resuscitation can cause significant dysregulation of critical systems, including the vascular endothelium. Following hemorrhage, the endothelial lining (glycocalyx) can shed, causing release of glycocalyx components, endothelial activation, and systemic inflammation. A canine model of hemorrhagic shock was used to evaluate five resuscitation fluids, including Lactated Ringers+Hetastarch, Whole Blood (WB), Fresh Frozen Plasma+packed Red Blood Cells (FFP+pRBC), and two hemoglobin-based oxygen carrier (HBOC) fluids, for their impact on glycocalyx shedding. Under anesthesia, purpose-bred adult canines were instrumented and subjected to a controlled hemorrhage with blood being drawn until a mean arterial pressure of <50 mmHg was reached or 40 % of the estimated blood volume was removed. Canines were left in shock for 45 mins before being resuscitated with one of the resuscitation fluids over 30 mins. Following resuscitation, the dogs were monitored up to 2 weeks. Following an additional 3–4 weeks for washout, the canines repeated the protocol, undergoing each resuscitation fluid individually. Blood samples were collected during each round at various timepoints for serum isolation, which was used for detection of glycocalyx biomarker. Comparison of baseline and post-hemorrhage alone showed a significant reduction in serum protein (p<0.0001), heparan sulfate (p<0.001), and syndecan-1 (p<0.0001) concentrations, and a significant increase in hyaluronan (p<0.0001) concentration. Intercomparisons of resuscitation fluids indicated minimal differences in glycocalyx markers over time. Comparisons within each fluid showed dynamic responses in glycocalyx biomarkers over time. Relative to individual baselines, syndecan-1 was significantly reduced after resuscitation in most cases (p<0.0001), excluding WB and FFP+pRBC. In all cases, VE-cadherin was significantly elevated at 24 hr compared to baseline (p<0.001). Hyaluronan was significantly elevated by 3 hr in all cases (p<0.01), except for HBOC fluids. Total glycosaminoglycans were significantly reduced only at 3 hr (p<0.001) for non-HBOC fluids. Similarly, heparan sulfate was significantly reduced with all fluids between resuscitation and 24 hr (p<0.01), except WB. The temporal changes in canine glycocalyx biomarkers were atypical of hemorrhage response in other species. This suggests that the hemorrhage lacked severity and/or typical glycocalyx biomarkers do not reflect the canine endothelium compared to other species. Further research is needed to characterize the canine endothelium and the response to resuscitation fluids.

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来源期刊
Veterinary journal
Veterinary journal 农林科学-兽医学
CiteScore
4.10
自引率
4.50%
发文量
79
审稿时长
40 days
期刊介绍: The Veterinary Journal (established 1875) publishes worldwide contributions on all aspects of veterinary science and its related subjects. It provides regular book reviews and a short communications section. The journal regularly commissions topical reviews and commentaries on features of major importance. Research areas include infectious diseases, applied biochemistry, parasitology, endocrinology, microbiology, immunology, pathology, pharmacology, physiology, molecular biology, immunogenetics, surgery, ophthalmology, dermatology and oncology.
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