Albumin resuscitation improves ventricular contractility and myocardial tissue oxygenation in rat endotoxemia.

Abstract

OBJECTIVE:

Fluid resuscitation to improve delivery of oxygen to vital organs is a principal clinical intervention for septic patients. We previously reported that albumin resuscitation in rat endotoxemia improved contractility in isolated cardiomyocytes, but whether this effect occurs in vivo is unknown. We hypothesized that albumin resuscitation would improve decreased ventricular contractility and myocardial tissue oxygenation in vivo.

DESIGN:

Randomized, controlled, prospective animal study.

SETTING:

University animal laboratory.

SUBJECTS:

Male Sprague-Dawley rats (250-350 g).

INTERVENTIONS:

Rats were randomized into three groups: control with no lipopolysaccharide (n = 8), lipopolysaccharide (10 mg/kg) without albumin resuscitation (n = 8), and lipopolysaccharide with albumin resuscitation (n = 6). Five hours after lipopolysaccharide injection, animals were resuscitated with 10 mL/kg 5% rat albumin in 0.9% saline. Six hours after 10 mL/kg lipopolysaccharide, a pressure-volume conductance catheter (MIKRO-Tip 2.0-Fr, Millar Instruments, Houston, TX) was inserted into the left ventricle to quantify maximum elastance as an index of contractility. Myocardial tissue Po2 was measured using a fiberoptic oxygen probe.

MEASUREMENTS AND MAIN RESULTS:

Maximum elastance decreased after lipopolysaccharide relative to control (47%, from 5.9 +/- 0.8 to 3.1 +/- 0.4 mm Hg/microL, p < .05). Albumin resuscitation prevented the lipopolysaccharide-induced decrease in maximum elastance (7.0 +/- 1.2 mm Hg/microL, p < .05 vs. lipopolysaccharide). Myocardial tissue Po2 was reduced in endotoxemia compared with control (53%, from 10.1 +/- 0.9 to 4.7 +/- 0.6 mm Hg, p < .05), and albumin resuscitation improved the lipopolysaccharide-induced tissue hypoxia toward the control value (9.0 +/- 1.4 mm Hg, p < .05).

CONCLUSIONS:

Albumin resuscitation improved decreased ventricular contractility and myocardial oxygenation in endotoxemic rats. This result suggests that albumin resuscitation may improve ventricular dysfunction by improving myocardial hypoxia.

• Authors: Chiho Tokunaga, Ryon M Bateman, John Boyd, Yingjin Wang, James A Russell, Keith R Walley
• Journal: Critical care medicine (Crit Care Med) Vol. 35 Issue 5 Pg. 1341-7 (May 2007) ISSN: 0090-3493 [Print] United States
• PMID: 17414087 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Albumins
• Endotoxins
• Hypoxia-Inducible Factor 1, alpha Subunit
• Lipopolysaccharides
• RNA, Messenger
• endotoxin, Escherichia coli
• Oxygen

Topics

• Albumins (pharmacology, therapeutic use)
• Animals
• Disease Models, Animal
• Endotoxemia (therapy)
• Endotoxins
• Escherichia coli
• Fluid Therapy (methods)
• Hypoxia (physiopathology)
• Hypoxia-Inducible Factor 1, alpha Subunit (metabolism)
• Lipopolysaccharides
• Male
• Myocardial Contraction (drug effects)
• Myocardium (metabolism)
• Oxygen (metabolism)
• RNA, Messenger (metabolism)
• Random Allocation
• Rats
• Rats, Sprague-Dawley
• Ventricular Function (drug effects)