Evidence map›Paper›PMID 16153427›Full record

ArticleSurgery2005

Direct energy delivery improves tissue perfusion after resuscitated shock.

El Rasheid Zakaria, William D Ehringer, Nina Tsakadze, Na Li, R Neal Garrison

Open access · greenAbstract read
In one paragraph

Article in Surgery, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Targeting ischemic penumbra: part I - from pathophysiology to therapeutic strategy.Journal of experimental stroke & translational medicine · 2010
    Article
  6. The Continued Promise of Neuroprotection for Acute Stroke Treatment.Journal of experimental stroke & translational medicine · 2008
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

El Rasheid ZakariaDepartment of Physiology and Biophysics, University of Louisville, KY 40292, USA. erzaka01@louisville.edu
William D Ehringer
Nina Tsakadze
Na Li
R Neal Garrison
Institute of Molecular Biology and Biophysics · RUVeterans Health Administration · US

Funding

Oxygen Carriers for Hypovolemic Circulatory CollapseR01HL076163 · NHLBI · SANGART, INC. · PI WINSLOW, ROBERT M · 2004 to 2007
$1.3M
Direct Peritoneal Resuscitation from Hypovolemic ShockR01HL076160 · NHLBI · UNIVERSITY OF LOUISVILLE · PI GARRISON, RICHARD N · 2004 to 2007
$872k
NHLBI NIH HHS R01 HL076160NHLBI NIH HHS R01 HL076163NHLBI NIH HHS R01 HL76163-01
6 · The paper itself

Abstract

backgroundConventional resuscitation (CR) from hemorrhagic shock (HS) does not restore intestinal blood flow. Indicators of anaerobic metabolism suggest that cellular energy production also is compromised. We hypothesize that the direct intravenous delivery of lipid-encapsulated high-energy phosphates to cells improves intestinal perfusion during HS and resuscitation (RES).

methodsMAP (MAP) was monitored in male rats (200 g), terminal ileum microvessel diameters were measured by in vivo videomicroscopy, and blood flow (Doppler velocimetry) was calculated. Cellular energy delivery was accomplished by intravenous infusion during RES of fusogenic unilamellar lipid vesicles that contain adenosine triphosphate (ATP; VitaSol). Our protocol was HS to 50% baseline MAP for 60 minutes, 30 minutes of RES, and continued microscopy observation for 120 minutes. Experimental groups (n=8 each) were HS+CR (group I); HS+CR+ VitaSol (group II); HS+CR+Vehicle, Vehicle is the phospholipid vesicles without magnesium ATP, (group III); HS+ VitaSol (group IV); sham-operated control+VitaSol (group V); and a time-matched sham-operated control (group VI). The survival outcome and total tissue water from wet weight/dry weight ratio as a function of adjunct VitaSol resuscitation were evaluated in separate intact animal experiments.

resultsHS caused a selective vasoconstriction of the intestinal inflow arterioles (100 microm), which was not seen in the smaller intestinal premucosal arterioles (7-15 microm). CR, which restored baseline hemodynamics, resulted in an initial restoration of intestinal microvascular diameters at all arteriolar levels. However, this was followed by a progressive vasoconstriction and hypoperfusion in premucosal vessels at 120 minutes after RES (-20.48% +/- 2.95% from baseline diameters). In contrast, VitaSol with CR caused enhanced premucosal dilation (+34.27% +/- 4.62%) and augmented flow (+20.50% +/- 10.70%) above prehemorrhage baseline. Vesicles alone had no effect, and VitaSol alone caused only a modest dilation. CR of moderate HS (40% of baseline MAP for 60 minutes, n=10) caused 20% mortality, whereas adjunct VitaSol resuscitation had a 100% survival and less tissue water content.

conclusionsOur data confirms that CR causes progressive intestinal hypoperfusion. Cellular resuscitation with direct intravenous energy delivery improves intestinal perfusion after CR and results in improved survival and less tissue edema.

Indexed as

Drug Delivery SystemsAdenosine TriphosphateAnimalsIleumMaleMicrocirculationRatsResuscitationShock, HemorrhagicSplanchnic CirculationAdenosine Triphosphate

Identifiers

PMID16153427
PMCPMC1361363
OpenAlexW2038222060

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.