Literature DB >> 16625118

Hypertonic saline resuscitation prevents hydrostatically induced intestinal edema and ileus.

Ravi S Radhakrishnan1, Hasen Xue, Stacey D Moore-Olufemi, Norman W Weisbrodt, Frederick A Moore, Steven J Allen, Glen A Laine, Charles S Cox.   

Abstract

OBJECTIVE: We have shown that acute edema induced by mesenteric venous hypertension (MV-HTN) impairs intestinal transit and reduces the standardized engineering measures of intestinal stiffness (elastic modulus) and residual stress (opening angle). We hypothesized that hypertonic saline (7.5%) would reverse these detrimental effects of acute edema.
DESIGN: Laboratory study.
SETTING: University laboratory.
SUBJECTS: Male Sprague Dawley rats (270-330 g).
INTERVENTIONS: Rats were randomized to five groups: sham, MV-HTN alone, MV-HTN with 4 mL/kg normal saline resuscitation (equal volume), MV-HTN with 33 mL/kg normal saline resuscitation (equal salt), and MV-HTN with 4 mL/kg hypertonic saline. Intestinal edema was measured by wet to dry tissue weight ratio. A duodenal catheter was placed and, 30 mins before death, fluorescein isothiocyanate Dextran was injected. At death, dye concentrations were measured to determine intestinal transit. Segments of distal ileum were hung to a fixed point in a tissue bath and to a force displacement transducer and stretched in increments of 1 mm; we recorded the new length and the corresponding force from the force displacement transducer to determine elastic modulus. Next, two transverse cuts were made yielding a 1- to 2-mm thick ring-shaped segment of tissue which was then cut radially to open the ring. Then the opening angle was measured.
MEASUREMENTS AND MAIN RESULTS: MV-HTN, MV-HTN with 4 mL/kg normal saline, and MV-HTN with 33 mL/kg normal saline caused a significant increase in tissue edema and a significant decrease in intestinal transit, stiffness, and residual stress compared with sham. Hypertonic saline significantly lessened the effect of edema on intestinal transit and prevented the changes in stiffness and residual stress.
CONCLUSIONS: Hypertonic saline prevented intestinal tissue edema. In addition, hypertonic saline improved intestinal transit, possibly through more efficient transmission of muscle force through stiffer intestinal tissue.

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Year:  2006        PMID: 16625118     DOI: 10.1097/01.CCM.0000218811.39686.3D

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  13 in total

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Journal:  J Trauma Acute Care Surg       Date:  2019-04       Impact factor: 3.313

2.  A murine model for the study of edema induced intestinal contractile dysfunction.

Authors:  S K Shah; S D Moore-Olufemi; K S Uray; F Jimenez; P A Walker; H Xue; R H Stewart; G A Laine; C S Cox
Journal:  Neurogastroenterol Motil       Date:  2010-06-28       Impact factor: 3.598

3.  Hypertonic saline resuscitation after emergent laparotomy and temporary abdominal closure.

Authors:  Tyler J Loftus; Philip A Efron; Trina M Bala; Martin D Rosenthal; Chasen A Croft; R Stephen Smith; Frederick A Moore; Alicia M Mohr; Scott C Brakenridge
Journal:  J Trauma Acute Care Surg       Date:  2018-02       Impact factor: 3.313

4.  Lymph transport in rat mesenteric lymphatics experiencing edemagenic stress.

Authors:  Elaheh Rahbar; Tony Akl; Gerard L Coté; James E Moore; David C Zawieja
Journal:  Microcirculation       Date:  2014-07       Impact factor: 2.628

5.  Sodium hydrogen exchanger as a mediator of hydrostatic edema-induced intestinal contractile dysfunction.

Authors:  Karen S Uray; Shinil K Shah; Ravi S Radhakrishnan; Fernando Jimenez; Peter A Walker; Randolph H Stewart; Glen A Laine; Charles S Cox
Journal:  Surgery       Date:  2011-01       Impact factor: 3.982

6.  Evaluating the potential role of nitric oxide as a mediator of hydrostatic edema mediated intestinal contractile dysfunction.

Authors:  Shinil K Shah; Hasen Xue; Fernando Jimenez; Alexander Y Kots; Byung-Kwon Choi; Karen S Uray; Peter A Walker; Stacey D Moore-Olufemi; Natalia Velez; Randolph H Stewart; Glen A Laine; Charles S Cox
Journal:  J Surg Res       Date:  2010-03-19       Impact factor: 2.192

7.  Hypertonic saline alters hydraulic conductivity and up-regulates mucosal/submucosal aquaporin 4 in resuscitation-induced intestinal edema.

Authors:  Ravi S Radhakrishnan; Shinil K Shah; Samuel H Lance; Hari R Radhakrishnan; Hasen Xue; Geetha L Radhakrishnan; Uma S Ramaswamy; Peter A Walker; Karen S Uray; Glen A Laine; Randolph H Stewart; Charles S Cox
Journal:  Crit Care Med       Date:  2009-11       Impact factor: 7.598

Review 8.  Resuscitation-induced intestinal edema and related dysfunction: state of the science.

Authors:  Shinil K Shah; Karen S Uray; Randolph H Stewart; Glen A Laine; Charles S Cox
Journal:  J Surg Res       Date:  2009-09-29       Impact factor: 2.192

9.  Hydrostatic intestinal edema induced signaling pathways: potential role of mechanical forces.

Authors:  Shinil K Shah; Lindsey N Fogle; Kevin R Aroom; Brijesh S Gill; Stacey D Moore-Olufemi; Fernando Jimenez; Karen S Uray; Peter A Walker; Randolph H Stewart; Glen A Laine; Charles S Cox
Journal:  Surgery       Date:  2010-01-25       Impact factor: 3.982

10.  Pretreatment with bone morphogenetic protein-7 (BMP-7) mimics ischemia preconditioning following intestinal ischemia/reperfusion injury in the intestine and liver.

Authors:  Ravi S Radhakrishnan; Geetha L Radhakrishnan; Hari R Radhakrishnan; Hasen Xue; Sasha D Adams; Stacey D Moore-Olufemi; Matthew T Harting; Charles S Cox; Bruce C Kone
Journal:  Shock       Date:  2008-11       Impact factor: 3.454

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