Article (Scientific journals)
Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock.
Ida, Keila; Otsuki, Denise Aya; Sasaki, Adolfo Toshiro Cotarelli et al.
2015In Critical Care, 19, p. 107
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Keywords :
Animals; Cerebrovascular Circulation/drug effects; Disease Models, Animal; Fluid Therapy; Hemodynamics/drug effects; Hypotension/drug therapy/etiology; Lypressin/analogs & derivatives/pharmacology/therapeutic use; Shock, Hemorrhagic/complications/drug therapy; Swine; Vasoconstrictor Agents/pharmacology/therapeutic use
Abstract :
[en] INTRODUCTION: We investigated whether treatment with terlipressin during recovery from hypotension due to haemorrhagic shock (HS) is effective in restoring cerebral perfusion pressure (CPP) and brain tissue markers of water balance, oxidative stress and apoptosis. METHODS: In this randomised controlled study, animals undergoing HS (target mean arterial pressure (MAP) 40 mmHg for 30 minutes) were randomised to receive lactated Ringer's solution (LR group; n =14; volume equal to three times the volume bled), terlipressin (TERLI group; n =14; 2-mg bolus), no treatment (HAEMO group; n =12) or sham (n =6). CPP, systemic haemodynamics (thermodilution technique) and blood gas analyses were registered at baseline, shock and 5, 30, 60 (T60), 90 and 120 minutes after treatment (T120). After the animals were killed, brain tissue samples were obtained to measure markers of water balance (aquaporin-4 (AQP4)), Na(+)-K(+)-2Cl(-) co-transporter (NKCC1)), oxidative stress (thiobarbituric acid reactive substances (TBARS) and manganese superoxide dismutase (MnSOD)) and apoptotic damage (Bcl-x and Bax). RESULTS: Despite the HS-induced decrease in cardiac output (CO) and hyperlactataemia, resuscitation with terlipressin recovered MAP and resulted in restoration of CPP and in cerebral protection expressed by normalisation of AQP4, NKCC1, TBARS and MnSOD expression and Bcl-x/Bax ratio at T60 and T120 compared with sham animals. In the LR group, CO and blood lactate levels were recovered, but the CPP and MAP were significantly decreased and TBARS levels and AQP4, NKCC1 and MnSOD expression and Bcl-x/Bax ratio were significantly increased at T60 and T120 compared with the sham group. CONCLUSIONS: During recovery from HS-induced hypotension, terlipressin was effective in normalising CPP and cerebral markers of water balance, oxidative damage and apoptosis. The role of this pressor agent on brain perfusion in HS requires further investigation.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Ida, Keila ;  Université de Liège > Dép. clinique des animaux de compagnie et des équidés (DCA) > Anesthésiologie et réanimation vétérinaires
Otsuki, Denise Aya
Sasaki, Adolfo Toshiro Cotarelli
Borges, Emilyn Silva
Castro, Leticia Urbano Cardoso
Sanches, Talita Rojas
Shimizu, Maria-Heloisa Massola
Andrade, Lucia Conceicao
Auler, Jose-Otavio Costa Jr
Dyson, Alex
Smith, Kenneth John
Rocha Filho, Joel Avancini
Malbouisson, Luiz-Marcelo Sa
More authors (3 more) Less
Language :
English
Title :
Effects of terlipressin as early treatment for protection of brain in a model of haemorrhagic shock.
Publication date :
2015
Journal title :
Critical Care
ISSN :
1364-8535
eISSN :
1466-609X
Publisher :
BioMed Central, United Kingdom
Volume :
19
Pages :
107
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 19 July 2017

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