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Delivery of low temperature volume replacement fluids increases inflammation in the rat cremaster muscle microcirculation model. A preliminary study.
Joanna Cwykiel, MSc, Jacek Szopinski, MD, PhD, Can Ozturk, MD and Maria Siemionow, MD, PhD, DSc
Cleveland Clinic
2013-03-15
Presenter: Joanna Cwykiel
Affidavit:
Joanna Cwykiel contributed to the study design and evaluation of microcirculatory data. She was also responsible for performing and analyzing of all real-time PCR data.
Director Name: Maria Siemionow MD Phd DSc
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Background: The aim of this study was to assess the effect of delivery of different temperature lactated Ringer solution (LRS) on the microcirculatory recordings, leukocyte-endothelium interactions and cytokine expression in the rat cremaster muscle model.
Methods: Rat cremaster muscle was dissected and exposed for microcirculatory recordings. Abdominal wall was exposed (2x3cm) without opening the peritoneum to imitate surgical injury and dehydration. The jugular vein was cannulated for fluid infusion and blood sampling. The tail artery was cannulated for invasive blood pressure monitoring and temperature recordings. The animals (n=40) were divided into 5 groups. Each group received different temperature LRS (1.5 ml every 1 hour): Group 1 -10°C, Group 2 -16°C, Group 3 – 21°C, Group 3 - 36°C and Group 4 - 40°C. Dehydration control group (Group 5) did not receive fluid augmentation. Microcirculatory hemodynamics of leukocyte-endothelium interactions were recorded every hour for 6 hours. At 0 and 6 hours blood samples were collected for arterial blood gas (ABG) test and real-time PCR to assess the expression of IL-1á, IL-1â, TNFá, IL-6 and ICAM-1.
Results: Application of LRS at temperatures of 10°C, 16°C and 21°C increased the level of lactates in the blood as well as the number of rolling, sticking and transmigrating leukocytes in comparison to 36°C and 40°C fluid at 6 hours post-surgery. This observation correlated with upregulated expression of proinflammatory factors: IL-1a, IL-1b, TNFa and ICAM-1.
Conclusions: Application of fluids with a temperature above 21°C can decrease the level of inflammation during hypovolemic shock and minimize tissue damage.
