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Effects of blood volume restitution following a portal hypertensive-related bleeding in anesthetized cirrhotic rats.

Abstract
The aim of this study was to investigate the influence of different strategies of blood volume restitution in the outcome of portal hypertension-related bleeding in anesthetized cirrhotic rats. Gastrointestinal hemorrhage was induced by sectioning a first order branch of the ileocolic vein in 38 cirrhotic rats (common bile duct ligation and occlusion). The subsequent hypovolemic shock was treated with no transfusion (n = 17), moderate transfusion (50% of expected blood loss, 5 mL, n = 11), and total transfusion (100% of expected blood loss, 10 mL, n = 10). At the end of the blood transfusion period (minute 15), mean arterial pressure (MAP) partially recovered in rats receiving moderate transfusion or no transfusion but decreased in the 10-mL transfusion group ( downward arrow 12 +/- 43%, P < .05 vs. no transfusion and 5 mL transfusion). After transfusion, groups given no or 5 mL transfusion remained hemodynamically stable. However, rats receiving 10 mL transfusion continued to deteriorate with persistent bleeding and progressive fall in MAP ( downward arrow 65 +/- 12%; P < .05 vs. no transfusion and 5 mL transfusion). Collected blood loss was significantly greater in the 10-mL group (20.0 +/- 1.5 g) than in groups given 5 mL (15.9 +/- 2.8 g; P < .05) or no transfusion (13.2 +/- 2.1 g; P < .05 vs. 10 mL and 5 mL transfusion). Survival in the no transfusion group was 47%. Rats given 5-mL transfusion had 64% survival. The worst survival was observed in the 10-mL transfusion group (0% survival; P < .05). We concluded that a transfusion policy aimed at completely replacing blood loss worsens the magnitude of bleeding and mortality from portal hypertensive-related bleeding in cirrhotic rats. On the contrary, moderate blood transfusion allowed hemodynamic stabilization and increased survival.
AuthorsB Castañeda, J Morales, R Lionetti, E Moitinho, V Andreu, S Pérez-Del-Pulgar, P Pizcueta, J Rodés, J Bosch
JournalHepatology (Baltimore, Md.) (Hepatology) Vol. 33 Issue 4 Pg. 821-5 (Apr 2001) ISSN: 0270-9139 [Print] United States
PMID11283845 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Animals
  • Blood Transfusion (methods)
  • Blood Volume
  • Gastrointestinal Hemorrhage (etiology, physiopathology, therapy)
  • Hemodynamics
  • Hypertension, Portal (complications, physiopathology)
  • Liver Cirrhosis (complications)
  • Male
  • Rats
  • Rats, Sprague-Dawley
  • Survival Analysis

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