Examination of the Diaphragm Following the Infusion of Different Fluid Resuscitation Therapies Post-Hemorrhagic Shock

2.50
Hdl Handle:
http://hdl.handle.net/10755/157158
Category:
Abstract
Type:
Presentation
Title:
Examination of the Diaphragm Following the Infusion of Different Fluid Resuscitation Therapies Post-Hemorrhagic Shock
Author(s):
Pierce, Janet; Knight, Amanda; Pierce, J. Thomas; Clancy, Richard; Slusser, Joyce
Author Details:
Janet Pierce, University of Kansas, Kansas City, Kansas, USA, email: jpierce@kumc.edu; Amanda Knight; J. Thomas Pierce; Richard Clancy; Joyce Slusser
Abstract:
PURPOSE: The first goal of this study was to compare the effects of different fluid resuscitation therapies on diaphragm shortening (DS), blood flow, hydrogen peroxide concentration, and apoptosis following hemorrhagic shock (HS). Our second goal was to evaluate the effects of dopamine on diaphragm performance by measuring diaphragm shortening, blood flow, apoptosis and hydrogen peroxide post-HS. BACKGROUND: Hemorrhagic shock is a leading cause of death among trauma patients. Proper fluid resuscitation management is crucial to treatment of patients who experience a hemorrhagic event. Intravenous fluids administered to HS patients may include lactated Ringer's (LR), dopamine (DA) and Hespan. To our knowledge, there are no published studies measuring diaphragm performance during HS with or without fluid resuscitation. METHODS: This was a randomized, controlled study using anesthetized male Sprague-Dawley rats. We measured arterial blood pressures, blood flow, respiratory rate, and DS. The change in diaphragm thickness during inspiration was used as an index of DS. Approx. 30% of blood volume was rapidly removed to elicit HS. After 60 min of HS, LR, LR + DA, Hespan or Hespan + DA was infused for 30 min. Half of the diaphragm was excised to measure apoptosis using fluorescent microscopy. The other half was used for hydrogen peroxide concentration using laser scanning cytometry. Blood flow was obtained employing fluorescent microspheres. Data were analyzed using mean +/- SD, and analysis of variance with mixed model. RESULTS: At baseline DS (mm) was 0.61 and significantly increased after 60 min of HS to 0.86. After infusing LR, DS decreased to 0.60, whereas with LR + DA DS was maintained at 0.92. DS during Hespan and Hespan + DA administration were 0.89 and 0.97 respectively. Before HS, diaphragm blood flow (mL/min/gm) was 0.75 and decreased to 0.57 post HS. Diaphragm blood flow was 0.46 for LR, 0.79 for LR + DA, 0.95 for Hespan, and 1.2 for Hespan + DA. Hydrogen peroxide concentration as measured by mean fluorescence intensity with LR = 8.4 E6, LR + DA = 2.0 E6, Hespan = 5.4 E6 and Hespan + DA = 1.7 E6. Percent diaphragm apoptosis was 34.5 for LR, 1.2 for LR + DA, 11.7 for Hespan, and 6.8 for Hespan + DA. CONCLUSIONS: Administering LR alone failed to maintain DS equal to that at 60 min of HS. However, with the other fluids, DS was maintained or increased. After infusion of the fluid therapies, diaphragm blood flow changes mirrored the alterations in DS. Hydrogen peroxide concentration with respect to LR alone was significantly reduced with the addition of DA and Hespan. In addition, percent diaphragm apoptosis with the administration of LR + DA, Hespan, and Hespan + DA were significantly less than LR only. Funded By: TSNRP Grant # HU0001-05-1-TS11.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleExamination of the Diaphragm Following the Infusion of Different Fluid Resuscitation Therapies Post-Hemorrhagic Shocken_GB
dc.contributor.authorPierce, Janeten_GB
dc.contributor.authorKnight, Amandaen_GB
dc.contributor.authorPierce, J. Thomasen_GB
dc.contributor.authorClancy, Richarden_GB
dc.contributor.authorSlusser, Joyceen_GB
dc.author.detailsJanet Pierce, University of Kansas, Kansas City, Kansas, USA, email: jpierce@kumc.edu; Amanda Knight; J. Thomas Pierce; Richard Clancy; Joyce Slusseren_GB
dc.identifier.urihttp://hdl.handle.net/10755/157158-
dc.description.abstractPURPOSE: The first goal of this study was to compare the effects of different fluid resuscitation therapies on diaphragm shortening (DS), blood flow, hydrogen peroxide concentration, and apoptosis following hemorrhagic shock (HS). Our second goal was to evaluate the effects of dopamine on diaphragm performance by measuring diaphragm shortening, blood flow, apoptosis and hydrogen peroxide post-HS. BACKGROUND: Hemorrhagic shock is a leading cause of death among trauma patients. Proper fluid resuscitation management is crucial to treatment of patients who experience a hemorrhagic event. Intravenous fluids administered to HS patients may include lactated Ringer's (LR), dopamine (DA) and Hespan. To our knowledge, there are no published studies measuring diaphragm performance during HS with or without fluid resuscitation. METHODS: This was a randomized, controlled study using anesthetized male Sprague-Dawley rats. We measured arterial blood pressures, blood flow, respiratory rate, and DS. The change in diaphragm thickness during inspiration was used as an index of DS. Approx. 30% of blood volume was rapidly removed to elicit HS. After 60 min of HS, LR, LR + DA, Hespan or Hespan + DA was infused for 30 min. Half of the diaphragm was excised to measure apoptosis using fluorescent microscopy. The other half was used for hydrogen peroxide concentration using laser scanning cytometry. Blood flow was obtained employing fluorescent microspheres. Data were analyzed using mean +/- SD, and analysis of variance with mixed model. RESULTS: At baseline DS (mm) was 0.61 and significantly increased after 60 min of HS to 0.86. After infusing LR, DS decreased to 0.60, whereas with LR + DA DS was maintained at 0.92. DS during Hespan and Hespan + DA administration were 0.89 and 0.97 respectively. Before HS, diaphragm blood flow (mL/min/gm) was 0.75 and decreased to 0.57 post HS. Diaphragm blood flow was 0.46 for LR, 0.79 for LR + DA, 0.95 for Hespan, and 1.2 for Hespan + DA. Hydrogen peroxide concentration as measured by mean fluorescence intensity with LR = 8.4 E6, LR + DA = 2.0 E6, Hespan = 5.4 E6 and Hespan + DA = 1.7 E6. Percent diaphragm apoptosis was 34.5 for LR, 1.2 for LR + DA, 11.7 for Hespan, and 6.8 for Hespan + DA. CONCLUSIONS: Administering LR alone failed to maintain DS equal to that at 60 min of HS. However, with the other fluids, DS was maintained or increased. After infusion of the fluid therapies, diaphragm blood flow changes mirrored the alterations in DS. Hydrogen peroxide concentration with respect to LR alone was significantly reduced with the addition of DA and Hespan. In addition, percent diaphragm apoptosis with the administration of LR + DA, Hespan, and Hespan + DA were significantly less than LR only. Funded By: TSNRP Grant # HU0001-05-1-TS11.en_GB
dc.date.available2011-10-26T19:28:24Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:28:24Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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