Protection of cerebral microcirculation, mitochondrial function and electrocortical activity by small-volume resuscitation with terlipressin in a model of haemorrhagic shock

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dc.contributor.author Ida, K. K.
dc.contributor.author Chisholm, Kim I.
dc.contributor.author Malbouisson, L. M. S.
dc.contributor.author Papkovsky, Dmitri B.
dc.contributor.author Dyson, Alex
dc.contributor.author Singer, M.
dc.contributor.author Duchen, Michael R.
dc.contributor.author Smith, K. J.
dc.date.accessioned 2018-05-02T10:16:26Z
dc.date.available 2018-05-02T10:16:26Z
dc.date.issued 2017
dc.identifier.citation Ida, K. K., Chisholm, K. I., Malbouisson, L. M. S., Papkovsky, D. B., Dyson, A., Singer, M., Duchen, M. R. and Smith, K. J. 'Protection of cerebral microcirculation, mitochondrial function, and electrocortical activity by small-volume resuscitation with terlipressin in a model of haemorrhagic shock', British Journal of Anaesthesia. 120(6), pp. 1245–1254. doi: 10.1016/j.bja.2017.11.074 en
dc.identifier.volume 120
dc.identifier.issued 6
dc.identifier.startpage 1
dc.identifier.startpage 1245
dc.identifier.endpage 10
dc.identifier.endpage 1254
dc.identifier.issn 0007-0912
dc.identifier.uri http://hdl.handle.net/10468/5945
dc.identifier.doi 10.1016/j.bja.2017.11.074
dc.description.abstract Background: During early treatment of haemorrhagic shock, cerebral perfusion pressure can be restored by small-volume resuscitation with vasopressors. Whether this therapy is improved with additional fluid remains unknown. We assessed the value of terlipressin and lactated Ringer's solution (LR) on the early recovery of the microcirculation, tissue oxygenation, and mitochondrial and electrophysiological function in the rat cerebral cortex. Methods: Animals treated with LR replacing three times (3LR) the volume bled (n=26), terlipressin (n=27), terlipressin plus 1LR (n=26), 2LR (n=16), or 3LR (n=15) were compared with untreated (n=36) and sham-operated rats (n=17) rats. In vivo confocal microscopy was used to assess cortical capillary perfusion, changes in tissue oxygen concentration, and mitochondrial membrane potential and redox state. Electrophysiological function was assessed by cortical somatosensory evoked potentials, spinal cord dorsum potential, and peripheral electromyography. Results: Compared with sham, haemorrhagic shock reduced the mean (standard deviation) area of perfused vessels [82% (sd 10%) vs 38% (12%); P<0.001] and impaired oxygen concentration, mitochondrial redox state [99% (4%) vs 59% (15%) of baseline; P<0.001], and somatosensory evoked potentials [97% (13%) vs 27% (19%) of baseline]. Administration of terlipressin plus 1LR or 2LR was able to recover these measures, but terlipressin plus 3LR or 3LR alone were not as effective. Spinal cord dorsum potential was preserved in all groups, but no therapy protected electromyographic function. Conclusions: Resuscitation from haemorrhagic shock using terlipressin with small-volume LR was superior to high-volume LR, with regard to cerebral microcirculation, and mitochondrial and electrophysiological function. en
dc.description.sponsorship Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES Ciencia sem Fronteiras #1064/61-24); Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2011/14386-2) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier en
dc.relation.uri https://www.sciencedirect.com/science/article/pii/S0007091217540672
dc.rights © 2017, the Authors. Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject Brain ischaemia en
dc.subject Confocal microscopy en
dc.subject Electrophysiology en
dc.title Protection of cerebral microcirculation, mitochondrial function and electrocortical activity by small-volume resuscitation with terlipressin in a model of haemorrhagic shock en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Dmitri Papkovsky, Biochemistry & Cell Biology, University College Cork, Cork, Ireland. +353-21-490-3000 Email: d.papkovsky@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Multiple Sclerosis Society
dc.contributor.funder National Multiple Sclerosis Society
dc.contributor.funder Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.contributor.funder Fundação de Amparo à Pesquisa do Estado de São Paulo
dc.contributor.funder Science Foundation Ireland
dc.description.status Peer reviewed en
dc.identifier.journaltitle British Journal of Anaesthesia en
dc.internal.IRISemailaddress d.papkovsky@ucc.ie en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2276/IE/I-PIC Irish Photonic Integration Research Centre/


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© 2017, the Authors. Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Except where otherwise noted, this item's license is described as © 2017, the Authors. Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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