Effects of Different Crystalloid Fluids on Renal Tissue in an Experimental Model of Hemorrhagic Shock.

Objective: The type of fluid that should be used in uncontrollable hemorrhages remains an area of research. This study was designed to compare the effects of resuscitation with Ringer's lactate (RL) solution versus a normal saline (NS) solution on hemodynamics, renal tissue histopathology, coagulation, and apoptosis in a rat model of hemorrhagic shock. Methods: The study employed groups designated as the control, hemorrhage, NS, and RL groups. Heart rate, mean arterial pressure, and respiratory rate were monitored. Annexin A5 values were assayed, rotational thromboelastometry analysis was performed, and excised kidney tissue samples were histopathologically analyzed. Results: Blood pressure levels were found to be significantly higher in the control group than those measured in the other groups. While the clotting time (CT) and clot formation time (CFT) in the hemorrhage group were significantly longer than those in the control and RL groups, the CT and CFT measured in the control group were significantly shorter compared to the RL group. The mean Annexin A5 level was in the hemorrhage group, which was significantly higher compared to the other groups. In the renal histopathological evaluation, the scores of proximal tubular injury, distal renal tubular injury, and interstitial renal tubular injury were found to be significantly lower in the control group compared to the other groups. Conclusion: This study demonstrated that NS or RL can be used safely to improve the hemodynamic symptoms resulting from hemorrhagic shock as a means to reduce apoptosis, and to decrease findings in favor of coagulopathy in bedside coagulation tests during the early stages of hemorrhagic shock until the time of starting a blood transfusion.

The effects of hydroxyethyl starch and gelatine on lung tissue and coagulation during the resuscitation of rats with traumatic haemorrhagic shock.

INTRODUCTION: This study was constructed to compare the effects of resuscitation with gelatine and hydroxyethyl starch (HES) on coagulopathy, haemodynamics, and tissue damage during an uncontrolled haemorrhagic shock model in rats. MATERIAL AND METHODS: Twenty 6-month-old Sprague-Dawley rats were included in the study and divided into 4 groups. There was no haemorrhage in the sham group. The others were randomised into haemorrhage without volume replacement (control group), haemorrhage and gelatine (group G), and haemorrhage and HES (group V). Blood samples for thromboelastogram and annexin 5 values were obtained before bleeding and after resuscitation. RESULTS: In the control group, R (16.18 ± 2.74) and K (5.8 ± 1.1) were significantly higher than in all other groups ( P = 0.001), and the TEG alpha angle was 39.54 ± 5.94°, which was found to be significantly lower than in the sham group ( P = 0.001). In group V, the TEG MA value was found to be significantly lower at 30.54 ± 8.89 ( P = 0.001). The annexin A5 value was significantly higher in the control group, group V, and group G than in the sham group and was highest in the control group ( P = 0.001). Lung damage score measurement was 0.60 ± 0.19 in the control group, higher than in the gelatine and HES groups ( P = 0.001). CONCLUSIONS: Lung tissue damage and coagulation were positively affected by HES or gelatine resuscitation. A reduction in clot formation in the HES group might be observed due to the possible negative effect on platelets. Therefore, we concluded that the use of gelatine might be advantageous until blood transfusion is initiated in traumatic haemorrhagic shock.

Combination Therapy of Gabapentin and N-Acetylcysteine Against Posttraumatic Epilepsy in Rats.

Traumatic brain injury (TBI) is a major public health problem worldwide that is associated with increased mortality and morbidity. Posttraumatic epilepsy (PTE) is one of the sequelae of TBI. The aim of this study was to investigate the role of N-acetylcysteine (NAC) as an adjuvant on the efficacy of levetiracetam (LEV) and gabapentin (GBP) in PTE model encouraged by pentylenetetrazol (PTZ) after mild-TBI in male Sprague-Dawley rats. Mild-TBI was performed by the weight-drop method in male Sprague-Dawley rats. PTE model was developed by injecting PTZ (30+15+15 mg/kg, 30 min intervals, i.p.) 7 days after head trauma. After the development of posttraumatic seizures, the rats were treated with NAC (100 mg/kg), LEV (50 mg/kg), GBP (100 mg/kg), NAC+LEV and NAC+GBP intraperitoneally for 14 days. Seizures related to PTE were scored by video-EEG recording. Motor performance of the animals was also evaluated in the rotarod test. 50 mg/kg LEV and 100 mg/kg GBP reduced seizures related to PTE. LEV alone (p = 0.009), but the administration of GBP+NAC (p = 0.015) was more effective on PTE-related seizure control. However, GBP+NAC application adversely affected the fall latency in the rotarod test. In terms of trauma-related seizure control, there was no statistically significant difference between the use of prophylactic LEV and symptomatic LEV. LEV alone or the combination of GBP with NAC provides more effective seizure control in the PTE facilitated by PTZ. On the other hand, the use of prophylactic LEV did not have any extra effect on posttraumatic seizure development and control.