Acta Cirúrgica Brasileira (Feb 2006)
Total hepatic ischemia and reperfusion after state controlled hemorrhagic shock, with used of different solutions: effects of neutrophils sequestration in kidney of rats
Abstract
PURPOSE: To evaluate and compare neutrophils sequestration in the renal cortex of rats, result of total hepatic ischemia and reperfusion after controlled hemorrhagic shock, with use of different electrolytic solutions. METHODS: Used 18 rats Wistar, males, adult, divided into three groups as the solution used to reanimation: Group PSS: physiologic saline solution; Group HSS: hypertonic saline hypertonic (7,5%) followed by lactated ringer's solution; Group LRS: lactated ringer's solution. All the animals were submitted to the bleeding controlled until mean arterial pressure (MAP) 40 mmHg, for 20 minutes. Performed volemic replacement until PAM=80 mmHg with the solution according the studied group, followed by laparotomy and Pringle's Maneuver for 15 minutes. The animals were accompanied until for two hours. To statistical comparisons between mean of neutrophils sequestration, in interstitium of the renal cortex, were made the tests One-way ANOVA and covariance analysis, adjusting itself for time of supervened. The hemodynamic parameters evaluated were: MAP, heat rate, cardiac index, vascular resistance system index. The analyzed metabolic variables were: pH, bicarbonate, base deficit and lactato, besides electrolytes. RESULTS: The mean values of supervened, in minutes, for group were: Group PSS 79,0±12,0; Group LRS 97,0±11,0; Group HSS 67,0±10. The mean values of neutrophils/field in the renal cortex were: Group PSS 0,55±0,68; Group LRS 1,68±0,53; Group HSS 1,33±0,43. When adjusted for time of supervened: Group PSS 0,55; Group LRS 1,62; Group HSS 1,39. There was statistically significant difference in neutrophils sequestration, between Group PSS regarding the others groups, using itself or not the adjustment by time of supervened (p=0,016 and p=0,0128). CONCLUSION: Both critical situations in this model, controlled hemorrhagic shock followed by Pringle's maneuver, promoted neutrophils sequestration in the interstitium renal of rat, and the physiologic saline solution demonstrated minor mean, differentiating statistically of the others solutions.
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