Intra-Colon Cooling Increases Survival Rate in the Rat Model of Lethal Hemorrhage

Author:

Arya Awadhesh K.1,Hu Kurt2,Chen Alice3,Olivas-Garcia Yamileck3,Coyne Christopher3,Tanaka Hideaki3,Liu Chunli3,Doucet Jay4,Chan Theodore3,Hu Bingren

Affiliation:

1. Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA

2. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

3. Departments of Emergency Medicine, University of California San Diego, San Diego, CA, USA.

4. Department of Surgery, Division of Trauma, University of California San Diego, San Diego, CA, USA.

Abstract

Abstract Background The objective of this study is to investigate whether Trans-Rectal Intra-Colon (TRIC) cooling can prolong the survival duration in a rat hemorrhagic shock (HS) model. Methods A lethal-HS was induced by bleeding 47% of the total blood volume. A TRIC device was placed into the colon to maintain the intra-colon temperature either at 37 °C (TRIC37°C) or TRIC10°C pos-HS. In the surface cooling (SC) rats, the body temperatures were maintained at the same level as the esophageal temperature of the TRIC10°C rats. A separated group of TRIC10°C rats were resuscitated (Res) at 90 minutes post-HS. A total six groups were: (i) Sham-TRIC37°C (n = 5); (ii) Sham-TRIC10°C (n = 5); (iii) HS-TRIC37°C (n = 5); (iv) HS-TRIC10°C (n = 6); (v) HS-SC (n = 6); and (vi) HS-TRIC10°C + Res (n = 6). Results An average post-HS survival time was 18.4 ± 9.4 minutes in HS TRIC37°C and 82 ± 27.82 minutes in the HS SC group. In striking contrast, the HS TRIC10°C group exhibited an average survival time of 150.2 ± 66.43 minutes. The post-HS blood potassium level rose significantly in the HS-TRIC37°C and HS-SC, whereas remained unchanged in the TRIC10°C groups. Post-HS intestinal damage occurred in HS-TRIC37°C and HS-SC groups but virtually absent in HS TRIC10°C groups. Following resuscitation at 90 min post-HS, all HS-TRIC10°C rats were fully recovered from the lethal HS. Conclusions TRIC10°C reversed the high blood potassium level, prevented the intestinal damage, and prolonged the survival duration by 6-fold relative to normothermia and by 2-fold compared to SC post-HS. All TRIC10°C rats were successfully resuscitated at 90 min post-HS.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Critical Care and Intensive Care Medicine,Emergency Medicine

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