Effects of hypertonic saline/hetastarch solution on stress response in heraorrhagic shock rabbit / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effects of hypertonic saline/hetastarch solution (HHS) on stress hormones and glucose metabolism in hemorrhagic shock rabbit.Methods Fourteen rabbits of both sexes weighing 2.2-2.6 kg were randomly divided into 2 groups HHS group ( n = 7) and lactated Ringer's solution (LRS) group ( n = 7). The animals were anesthetized with intravenous 20% urethane 5 ml? kg-1 . Femoral artery was cannulated for BP monitoring and femoral vein was cannulated for removal of blood and fluid infusion. Hemorrhagic shock was induced according to Wiggers. MAP was maintained at 45 mm Hg for 45 min. Then the animals in HHS group received HHS 6 ml? kg-1 and those in LRS group LRS 6 ml? kg-1 . Venous blood samples were taken before shock (baseline), during shock before resuscitation, and 30, 60, 120 min after fluid resuscitation for determination of plasma epinephrine, glucagon, insulin and blood glucose concentration. The insulin sensitivity index (ISI) was calculated.Results After resuscitation MAP returned to baseline level in HHS group while in LRS group MAP was still lower than the baseline. The plasma epinephrine, glucagon and blood glucose concentration increased significantly while plasma insulin concentration decreased significantly during shock before fluid resuscitation compared to the baseline in both groups. After fluid resuscitation plasma epinephrine and glucagon concentration decreased significantly and plasma insulin concentration increased significantly in HHS group whereas in LRS group plasma epinephrine, glucagon and insulin concentration kept increasing. The blood glucose level was significantly lower at 60 and 120 min after resuscitation in HHS group than in LRS group. ISI was decreased after resuscitation in both groups but was significantly lower at 60 and 120 min after resuscitation in LRS group than in HHS group.Conclusion Resuscitation with HHS can reduce the stress response and ameliorate the decrease in insulin sensitivity during hemorrhagic shock.