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.authorIda, K. K.
dc.contributor.authorChisholm, Kim I.
dc.contributor.authorMalbouisson, L. M. S.
dc.contributor.authorPapkovsky, Dmitri B.
dc.contributor.authorDyson, Alex
dc.contributor.authorSinger, M.
dc.contributor.authorDuchen, Michael R.
dc.contributor.authorSmith, K. J.
dc.contributor.funderMultiple Sclerosis Society
dc.contributor.funderNational Multiple Sclerosis Society
dc.contributor.funderCoordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.contributor.funderFundação de Amparo à Pesquisa do Estado de São Paulo
dc.contributor.funderScience Foundation Ireland
dc.date.accessioned2018-05-02T10:16:26Z
dc.date.available2018-05-02T10:16:26Z
dc.date.issued2017
dc.description.abstractBackground: 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.sponsorshipCoordenação 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationIda, 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.2017.11.074en
dc.identifier.doi10.1016/j.bja.2017.11.074
dc.identifier.endpage10
dc.identifier.endpage1254
dc.identifier.issn0007-0912
dc.identifier.issued6
dc.identifier.journaltitleBritish Journal of Anaesthesiaen
dc.identifier.startpage1
dc.identifier.startpage1245
dc.identifier.urihttps://hdl.handle.net/10468/5945
dc.identifier.volume120
dc.language.isoenen
dc.publisherElsevieren
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2276/IE/I-PIC Irish Photonic Integration Research Centre/
dc.relation.urihttps://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.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectBrain ischaemiaen
dc.subjectConfocal microscopyen
dc.subjectElectrophysiologyen
dc.titleProtection of cerebral microcirculation, mitochondrial function and electrocortical activity by small-volume resuscitation with terlipressin in a model of haemorrhagic shocken
dc.typeArticle (peer-reviewed)en
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