Hypertonic
sodium pyruvate (HSP), as well as
ethyl pyruvate solutions, has been proposed as resuscitative fluids in the treatment of
hemorrhagic shock (HS) because of their anti-inflammatory and
antioxidant properties. The effectiveness of one
pyruvate preparation over the other in the treatment of HS has not been evaluated. The authors aimed to compare two
pyruvate solutions for
resuscitation and their mechanisms of action in rats during HS. The effects of infusion of low-volume HSP were compared against high-volume
Ringer's ethyl pyruvate on hemodynamic parameters, inflammatory cascade, and regulation of stress and apoptosis-related
proteins in the liver. Sprague-Dawley rats were either treated as
sham animals or subjected to computer-controlled arterial
hemorrhage (40 mmHg) for 60 min followed by
resuscitation with isotonic
sodium chloride solution, hypertonic saline,
Ringer's lactate solution,
Ringer's ethyl pyruvate, or HSP for 60 min. Animals were continuously monitored for hemodynamic and biochemical parameters in blood. At the end of the experiment, animals were killed, and liver samples were taken for the evaluation of inflammatory and anti-inflammatory markers and mediators of oxidative stress, liver injury, and expression of apoptotic signaling
proteins. In comparison with
Ringer's ethyl pyruvate, HSP administration after
hemorrhage reduced liver injury, which was associated with increased levels of serum and tissue inflammatory
cytokines, inflammatory mediators such as NOS and
cyclooxygenase 2, lipid peroxidation, and higher hepatocellular
adenosine triphosphate. Cellular apoptotic events related to the activation of
caspase-3 and
poly(ADP-ribose)polymerase cleavage were also decreased by
sodium pyruvate.
Resuscitation with small-volume HSP offers significant protection against inflammatory and oxidative stress and in preventing liver injury compared with large-volume
Ringer's ethyl pyruvate.