A new
drug,
trans sodium crocetinate (
TSC), has been suggested for use in
resuscitation after
trauma.
TSC has been shown to increase survival in a rat model of
hemorrhagic shock. It also results in an increase in blood pressure and a decrease in plasma
lactate levels when given immediately after
hemorrhage.
TSC increases whole-body oxygen consumption rates, and it is thought that its physiological effects are due to the increased
oxygen availability. In fact,
TSC therapy and 100%
oxygen therapy show similar results when used in the same rat
hemorrhage model. It has been suggested, however, that 100%
oxygen therapy is effective only if begun immediately after
hemorrhage. Such a window of opportunity has been said to exist for other
resuscitation methods; thus, the current study is to determine if this is true for
TSC. In one series of experiments, rats were bled 60% of their blood volumes and given an injection of
TSC (or saline) 20 min after the
hemorrhage ended. The injection was then repeated four times, spaced 10 min apart. Thirty minutes after the final injection, the animals were infused with
normal saline.
TSC again restored blood pressure and other parameters, but repeated dosing was necessary. In addition, this
therapy prevented an increase in liver
enzymes (
transaminases) as measured 24 h after
hemorrhage. In a second study, rats were bled 60% of their blood volumes, followed by a second
bleeding (an additional 10%) done 10 min later. No subsequent fluid was infused in this group. The majority of the animals treated with
TSC after the second
hemorrhage survived, whereas the controls did not. These data suggest that
TSC is effective when given after a delay. The dosing regimen must be different, however, presumably because of the blood
acidosis that develops after
hemorrhage. The results also suggest that
TSC may be protective against secondary liver damage resulting from
trauma.