In vitro and in vivo resuscitation with adenosine retains cardiomyocyte structure and function following hemorrhagic shock in rats

Successful treatment of hemorrhage requires restoration of normal cardiac function following resuscitation. However, many interventions used to attempt to restore cardiac function may cause additional myocardial injury, cardiac dysfunction and failure. The purpose of this study was to examine the ability of therapeutic intervention using adenosine to protect the heart from contractile dysfunction and post-resuscitation injury following hemorrhagic shock. Male Spargue-Dawley rats were divided into 3 groups: 1] In vivo hemorrhagic shock [1hour] followed by in vitro treatment with adenosine and ex vivo resuscitation using the Langendorff apparatus [60 minutes], 2] In vivo hemorrhagic shock [1 hour] followed by in vivo treatment with 20 microM adenosine and resuscitation [30 minutes] then ex vivo perfusion [60 minutes] and 3] In vivo hemorrhagic shock [2 hours] followed by in vivo treatment with 20 microM adenosine and resuscitation [30 minutes] then ex vivo perfusion [60 minutes]. Arterial blood samples were collected for measurements of TNF-alpha. Treatment with adenosine before resuscitation from hemorrhagic shock significantly improved left ventricular contractile function compared to the untreated resuscitated group. Treatment with adenosine also decreased the inflammatory response to shock by lowering the levels of TNF. In conclusion, treatment with adenosine before resuscitation of hemorrhagic shock protected the heart from post-resuscitation myocardial dysfunction and injury in rats