Hypertonic Saline Dextran Attenuates Leukocyte Accumulation in the Liver after Hemorrhagic Shock and Resuscitation

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Abstract
Hemorrhagic shock and resuscitation triggers a global ischemia/reperfusion phenomenon, in which activated leukocytes are considered strong contributors to the ensuing tissue damage. The aim of the study was to investigate the effects of hypertonic saline dextran (HSD) on the early leukocyte/endothelial interactions (intravital fluorescence microscopy) in a rat model of hemorrhagic shock (1 hour at mean arterial pressure of 40 mm Hg). The resuscitation was performed with lactated Ringer's solution (RL, four times shed blood/20 minutes, n = 6), 6% dextran 60 (DEX, 100% shed blood/5 minutes, n = 8), and 7.2% NaCl/10% dextran 60 (HSD, 10% shed blood/2 minutes, n = 8). After 1 hour of resuscitation, shock-induced stasis/adherence of leukocytes was further enhanced with RL (sinusoids 17.6 +/- 6.9%; venules 33.9 +/- 8.5%), whereas DEX and HSD attenuated leukocyte stagnation in sinusoids (DEX -7.4 +/- 6,1%; HSD -14.7 +/- 2.9%, p < 0.01 vs. RL) and leukocyte adherence in postsinusoidal venules (DEX -12.2 +/- 8.6%, p < 0.05 vs. RL; HSD -27 +/- 7.4%, p < 0.01 vs. RL). HSD reduced significantly the number of leukocytes accumulated in the liver after resuscitation of hemorrhagic shock, probably due to a combination of mechanisms of both components.