Resuscitation with adenosine retains cardiomyocyte structure following hemorrhagic shock in rats

ABSTRACT

Despite the improvement in resuscitation strategies, the incidence of post-resuscitation myocardial injury and failure remains high. Hemorrhagic shock activates an inflammatory response that can lead to myocardial cellular injury. Adenosine has been shown to protect the heart against ischemia reperfusion injury. However, the cardioprotective effects of adenosine following hemorrhagic shock may reduce myocardial injury by decreasing the inflammatory response to shock in rats. After 60 min on hemorrhage, 10 rats were randomized in vivo resuscitation with [n=8] microM adenosine for 30 min. heart Biopsies were collected from histological and electron microscopy examination. Light microscopy demonstrated decreased neutrophil infiltration, absence of contraction band necrosis and hydropic degeneration in the adenosine treated group compared to the hemorrhage untreated. Electron microscopy showed relative preservation of myocardial structure with absence of mitochondrial swelling in the hemorrhage treated group. These findings suggest that treatment with adenosine before in vivo resuscitation of hemorrhagic shock protected the heart from post-resuscitation myocardial injury in rats and the mechanism could be mediated by lowering the inflammatory response to shock