The Protective Effect Of Hypertonic Saline Plus Hydroxyethyl Starch Solution On Lung And Intestinal Mucosa Barrier Function After Hemorrhagic Shock

Background and Objective: A number of studies have shown that 7.5% NaCl hypertonic saline solution (HTS) used for small-volume resuscitation from hemorrhagic shock is effective to restore systemic and splanchnic hemodynamics, improve intestinal mucosa barrier function, suppress inflammatory response, and alleviate lung injury after hemorrhagic shock. But the time is short in maintaining stable hemodynamics. Hydroxyethyl starch (HES, 200/0.5) 6% solution may extend blood volume as 1:1 proportion and maintain for 4-8 hours. The molecule of hydroxyethyl starch (HES, 200/0.5) can block the enlarged microholes on the base membrane of capillary vessel induced by shock, which reduces plasma effusion and tissue edema. The goal of this experiment was to test the hypothesis that 7.5% NaCl plus 6% hydroxyethyl starch (200/0.5) compound solution (HHS) used for resuscitation from hemorrhagic shock would be more effective than HTS alone in maintaining hemodynamics stably and protecting the lung and intestinal mucosa barrier function after hemorrhagic shock. And elementarily analyze the correlation between lung injury and intestinal mucosa barrier injury.Material and Methods: Randomly divided 30 male SD rats into five groups (n=6). The sham shock group was control group (CON group). The second to the five groups were all variations of hemorrhagic shock groups with blood withdrawn to MAP of 45 mmHg(1 mmHg = 0.133 kpa). This was maintained for 120 minutes by withdrawing or reinfusing blood, and then with no resuscitation (SH group), with 5ml?kg-1 7.5% NaCl plus 6% hydroxyethyl starch (200/0.5) compound solution (HHS group), with 5ml?kg-1 7.5% NaCl solution (HTS group), and with Lactated Ringer's solution three times the volume of the shed blood (LR group). Record MAP and CVP for 3h after the resuscitation. And the oxygenation index (PaO2/FiO2) at 2h and 24h, the lung water content, the pulmonary myeloperoxidase (MPO) levels, and lung damage scores at 24h were assessed respectively. And the endotoxin levels of plasma were evaluated before shedding blood and at 3h or 24h after resuscitation. The liver, mesenteric lymph nodes (MLN),...