Comparison of the trometamol-balanced solution with two other crystalloid solutions for fluid resuscitation of a rat hemorrhagic model

Yih-Sharng Chen; Jih-Jong Lee; Wen-Ting Ting; Ru-Wen Chang; Chih-Hsien Wang

doi:10.4142/jvs.2020.21.e6

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Chen, Lee, Ting, Chang, and Wang: Comparison of the trometamol-balanced solution with two other crystalloid solutions for fluid resuscitation of a rat hemorrhagic model

Original Article Emergency & Critical Care

J Vet Sci 2020;21(1):e6.

Published online: 4 January 2020

DOI: https://doi.org/10.4142/jvs.2020.21.e6

Comparison of the trometamol-balanced solution with two other crystalloid solutions for fluid resuscitation of a rat hemorrhagic model

Yih-Sharng Chen², Jih-Jong Lee^1,^3,^4,^*, Wen-Ting Ting^1,^2,³, Ru-Wen Chang², Chih-Hsien Wang²

¹Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan

²Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, National Taiwan University, Taipei 10002, Taiwan

³Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei 10672, Taiwan

⁴Animal Cancer Treatment Center, National Taiwan University Veterinary Hospital, Taipei 10672, Taiwan

^*Corresponding authors: Jih-Jong Lee Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, No. 153, Sec. 3, Keelung Rd., Da' an Dist., Taipei 10672, Taiwan. E-mail: jacklee@ntu.edu.tw

^*Yih-Sharng Chen Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, National Taiwan University, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei 10002, Taiwan. E-mail: yschen1234@gmail.com

Received 18 May 2019 Revised 30 September 2019 Accepted 21 October 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Currently, the optimal resuscitation fluid remains debatable. Therefore, in the present study, we designed a trometamol-balanced solution (TBS) for use as a resuscitation fluid for hemorrhagic shock. Hemorrhagic shock was induced in 18 male Wistar-Kyoto rats, which were assigned to normal saline (NS), Ringer's solution (RS), and TBS groups. During the hemorrhagic state, their hemodynamic parameters were recorded using an Abbott i-STAT analyzer with the CG4+ cartridge (for pH, pressure of carbon dioxide, pressure of oxygen, total carbon dioxide, bicarbonate, base excess, oxygen saturation, and lactate), the CG6+ cartridge (for sodium, potassium, chloride, blood glucose, blood urea nitrogen, hematocrit, and hemoglobin), and enzyme-linked immunosorbent assay kits (calcium, magnesium, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, and albumin). Similar trends were found for the parameters of biochemistries, electrolytes, and blood gas, and they revealed no significant changes after blood withdrawal-induced hemorrhagic shock. However, the TBS group showed more effective ability to correct metabolic acidosis than the NS and RS groups. TBS was a feasible and safe resuscitation solution in this study and may be an alternative to NS and RS for resuscitation in hemorrhagic shock patients without liver damage.

Keywords: Resuscitation fluid, normal saline, Ringer's solution, hemorrhagic model

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Fig. 1.

(A) Na, (B) Cl, and (C) K concentrations at baseline and after BW-induced hemorrhagic shock. Na, sodium; BW, blood withdrawal; NS, normal saline; RS, Ringer's solution; TBS, trometamol-balanced solution. * p < 0.05 between the NS and TBS groups; ^† p < 0.05 between the RS and TBS groups.

Fig. 2.

(A) Lactate, (B) BUN, and (C) glucose concentrations at baseline and after BW-induced hemorrhagic shock. BW, blood withdrawal; NS, normal saline; RS, Ringer's solution; TBS, trometamol-balanced solution; BUN, blood urea nitrogen. * p < 0.05 between the NS and TBS groups.

Fig. 3.

(A) Cre, (B) Mg, (C) AST, and (D) ALT concentrations at baseline and after BW-induced hemorrhagic shock. Cr, creatinine; BW, blood withdrawal; NS, normal saline; RS, Ringer's solution; TBS, trometamol-balanced solution; Mg, magnesium; AST, aspartate aminotransferase; ALT, alanine aminotransferase.

Fig. 4.

(A) Ca and (B) albumin (C) Hct and (D) Hgb concentrations at baseline and after BW-induced hemorrhagic shock. Ca, calcium; BW, blood withdrawal; NS, normal saline; RS, Ringer's solution; TBS, trometamol-balanced solution; Hct, hematocrit; Hgb, hemoglobin.

Fig. 5.

(A) pH, (B) P CO₂, (C) P O₂, (D) TCO₂, (E) HCO₃, (F) BE, and (G) sO₂ levels at baseline and after BW-induced hemorrhagic shock. BW, blood withdrawal; NS, normal saline; RS, Ringer's solution; TBS, trometamol-balanced solution; P CO₂, pressure of carbon dioxide; P O₂, pressure of oxygen; TCO₂, total carbon dioxide; HCO₃, bicarbonate; BE, base excess; sO₂, oxygen saturation. * p < 0.05 between the NS and TBS groups.

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