Hypertonic saline and hemorrhagic shock: hepatocellular function and integrity after six hours of treatment.

Abstract

PURPOSE: The comparison after 6 h of hemorrhagic shock (HS) treatment with NaCl 7.5% (Hypertonic Saline Solution-SSH) or Ringer Lactate (RL) on liver function and integrity. METHODS: Male Wistar rats were submitted to HS (Mean Arterial Pressure-MAP= 45 mmHg) during 60 min and then treated with NaCl 7.5% (SSH, 10% of blood loss, n=8) or Ringer Lactate (RL, 400% of blood loss, n=8). After 6 h rats were anesthetized, hepatic function was assessed by bile flow measurement and liver integrity evaluated by determination of alanine aminotransferase (ALT) and bilirubin activities. RESULTS: There was no difference in MAP between the groups during the whole experiments. Biliary flow showed a significant recovery after SSH treatment (p<0.05), and significant decrease of ALT (p<0.001) and bilirubin levels (p<0.001) in comparison to RL. CONCLUSION: Resuscitation of HS with NaCl 7.5% promoted better recovery of liver function and lesser hepatocellular damage after 6 h of treatment compared to RL. The improvement is very likely related to increased microvascular perfusion provided by small volume resuscitation.