Fluid Resuscitation Attenuates Early Cytokine mRNA Expression after Peritonitis

Autor: William G. Cheadle, P. J. Downard, Q Qian, M C Chou, Mark A. Wilson, David A. Spain, Richard N. Garrison
Rok vydání: 1996
Předmět:
Zdroj: The Journal of Trauma: Injury, Infection, and Critical Care. 41:622-627
ISSN: 1079-6061
DOI: 10.1097/00005373-199610000-00005
Popis: Objective : To study the hypothesis that fluid resuscitation alters cytokine gene expression after experimental murine peritonitis. Materials and Methods : Mice underwent cecal ligation and puncture (CLP) to induce peritonitis and were randomized to receive variable amounts of normal saline (0, 0.25, 1.0 mL subcutaneously) and serum (0 or 0.1 mL) after operation. Hepatic and small intestinal (ileal) tissue were harvested at 3 or 6 hours after CLP, and total tissue RNA was extracted. Reverse transcriptase polymerase chain reaction was used to provide relative quantitation of tumor necrosis factor-α and interleukin (IL)-1β messenger RNA (mRNA) compared with β-actin. Results : CLP without resuscitation resulted in significant increases in hepatic tumor necrosis factor-α mRNA (1190% at 6 hours compared with normal animals), and IL-1β mRNA (1475%), and intestinal IL-1β mRNA (1243%). Volume administration attenuated cytokine expression at both 3 and 6 hours, and saline seemed to have more potent effects than serum. The volume of resuscitation correlated with survival at 18 hours. Survival in the saline (1 mL) + serum group was 90% at 18 hours compared with 20 to 40% in the groups with little or no resuscitation. Overall, there were no survivors at 30 hours. Conclusions : Fluid resuscitation (amount, composition, timing) should be an important consideration in the utilization of experimental infection models. Furthermore, optimization of the patient's intravascular volume status during sepsis may have important effects on immune responses, in addition to improving hemodynamic variables.
Databáze: OpenAIRE