Resuscitation from traumatic hemorrhagic shock with Na+/H+ exchanger inhibitor

D. Wu, H. Dai, J. Arias, L. Latta, W. M. Abraham

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Severe hemorrhage from traumatic injury is a major causative factor in almost half of these deaths on the battlefield, especially during the early period (<2h) after injury. Intervention with low-volume fluid resuscitation is increasingly preferred than more aggressive fluid replacement. We evaluated the use of a Na+/H+ exchanger (NHE) inhibitor, as a cardioprotective adjunct therapy to low-volume resuscitation in a rat model of traumatic hemorrhagic shock. Methods: Femur fracture with soft tissue injury was induced in 28 anesthetized male rats. The animals were then bled via the carotid artery to maintain a mean arterial pressure of 40 mmHg for 20 minutes. Groups: 1) no therapy; 2) 15 ml/kg Hextend infusion over 40 minutes; 3) 3 mg/kg BIIB513 (NHE-1 inhibitor) + 15 ml/kg Hextend infusion over 40 minutes. After 4 hours, the animals who survived received a second infusion of Hextend. The experiment was terminated at 6 hours after initial resuscitation. Data are reported as mean ± SD. Results: All animals in the no therapy group died within 2 hours. Compared to Hextend infusion alone, the addition of NHE-1 inhibition with BIIB513, improved the hemodynamic response to fluid resuscitation (Fig 1), increased blood oxygen content, prevented metabolic acidosis, and improved 6 hour survival (42% in Hextend group vs 80% in BIIB513 + Hextend group). NHE-1 inhibition also resulted in reduced plasma levels of TNF-α, ICAM-1 and C-reactive protein, and attenuated neutrophil infiltration in the liver. Conclusion: NHE-1 inhibition with BIIB513 improved the hemodynamic response to fluid resuscitation, attenuated tissue inflammatory mediators, and most importantly improved survival.

Original languageEnglish
Title of host publicationIFMBE Proceedings
Pages307-308
Number of pages2
Volume24
DOIs
StatePublished - Nov 6 2009
Externally publishedYes
Event25th Southern Biomedical Engineering Conference 2009 - Miami, FL, United States
Duration: May 15 2009May 17 2009

Other

Other25th Southern Biomedical Engineering Conference 2009
CountryUnited States
CityMiami, FL
Period5/15/095/17/09

Fingerprint

Resuscitation
Sodium-Hydrogen Antiporter
Animals
Fluids
Hemodynamics
Rats
Tissue
Intercellular Adhesion Molecule-1
Infiltration
Liver
C-Reactive Protein
Blood
Oxygen
Proteins
Plasmas
Experiments

Keywords

  • Metabolic acidosis
  • Organ function
  • Proinflammatory mediator
  • Traumatic hemorrhagic shock

ASJC Scopus subject areas

  • Biomedical Engineering
  • Bioengineering

Cite this

Wu, D., Dai, H., Arias, J., Latta, L., & Abraham, W. M. (2009). Resuscitation from traumatic hemorrhagic shock with Na+/H+ exchanger inhibitor. In IFMBE Proceedings (Vol. 24, pp. 307-308) https://doi.org/10.1007/978-3-642-01697-4_108

Resuscitation from traumatic hemorrhagic shock with Na+/H+ exchanger inhibitor. / Wu, D.; Dai, H.; Arias, J.; Latta, L.; Abraham, W. M.

IFMBE Proceedings. Vol. 24 2009. p. 307-308.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Wu, D, Dai, H, Arias, J, Latta, L & Abraham, WM 2009, Resuscitation from traumatic hemorrhagic shock with Na+/H+ exchanger inhibitor. in IFMBE Proceedings. vol. 24, pp. 307-308, 25th Southern Biomedical Engineering Conference 2009, Miami, FL, United States, 5/15/09. https://doi.org/10.1007/978-3-642-01697-4_108
Wu D, Dai H, Arias J, Latta L, Abraham WM. Resuscitation from traumatic hemorrhagic shock with Na+/H+ exchanger inhibitor. In IFMBE Proceedings. Vol. 24. 2009. p. 307-308 https://doi.org/10.1007/978-3-642-01697-4_108
Wu, D. ; Dai, H. ; Arias, J. ; Latta, L. ; Abraham, W. M. / Resuscitation from traumatic hemorrhagic shock with Na+/H+ exchanger inhibitor. IFMBE Proceedings. Vol. 24 2009. pp. 307-308
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