ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2009
Hemorrhage-induced hepatic injury and hypoperfusion can be prevented by direct peritoneal resuscitation.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 28 citations in OpenAlex.
- Inflammation-linked adipokine profiles associate with acute organ dysfunction after severe trauma.Journal of translational medicine · 2026Article
- Navigating Hemorrhagic Shock: Biomarkers, Therapies, and Challenges in Clinical Care.Biomedicines · 2024Review
- Comparison of the trometamol-balanced solution with two other crystalloid solutions for fluid resuscitation of a rat hemorrhagic model.Journal of veterinary science · 2020Article
- Impact of initial temporary abdominal closure in damage control surgery: a retrospective analysis.World journal of emergency surgery : WJES · 2018Article
- Protective role of nuclear factor erythroid 2-related factor 2 in the hemorrhagic shock-induced inflammatory response.International journal of molecular medicine · 2016Article
- Hepatic Shock Differential Diagnosis and Risk Factors: A Review Article.Hepatitis monthly · 2015Review
- Resuscitation after hemorrhagic shock: the effect on the liver--a review of experimental data.Journal of anesthesia · 2013Review
- Preservation of hepatic blood flow by direct peritoneal resuscitation improves survival and prevents hepatic inflammation following hemorrhagic shock.American journal of physiology. Gastrointestinal and liver physiology · 2012Article
- Plant polyphenols attenuate hepatic injury after hemorrhage/resuscitation by inhibition of apoptosis, oxidative stress, and inflammation via NF-kappaB in rats.European journal of nutrition · 2012Article
- Direct peritoneal resuscitation accelerates primary abdominal wall closure after damage control surgery.Journal of the American College of Surgeons · 2010Article
- [Long-term liver damage due to trauma].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2009Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundCrystalloid fluid resuscitation after hemorrhagic shock (HS) that restores/maintains central hemodynamics often culminates in multi-system organ failure and death due to persistent/progressive splanchnic hypoperfusion and end-organ damage. Adjunctive direct peritoneal resuscitation (DPR) using peritoneal dialysis solution reverses HS-induced splanchnic hypoperfusion and improves survival. We examined HS-mediated hepatic perfusion (galactose clearance), tissue injury (histopathology), and dysfunction (liver enzymes).
methodsAnesthetized rats were randomly assigned (n = 8/group): (1) sham (no HS); (2) HS (40% mean arterial pressure for 60 min) plus conventional i.v. fluid resuscitation (CR; shed blood + 2 volumes saline); (3) HS + CR + 30 mL intraperitoneal (IP) DPR; or (4) HS + CR + 30 mL IP saline. Hemodynamics and hepatic blood flow were measured for 2 h after CR completion. In duplicate animals, liver and splanchnic tissues were harvested for histopathology (blinded, graded), hepatocellular function (liver enzymes), and tissue edema (wet-dry ratio).
resultsGroup 2 decreased liver blood flow, caused liver injuries (focal to submassive necrosis, zones 2 and 3) and tissue edema, and elevated liver enzymes (alanine aminotransferase (ALT), 149 +/- 28 microg/mL and aspartate aminotransferase (AST), 234 +/- 24 microg/mL; p < 0.05) compared to group 1 (73 +/- 9 and 119 +/- 10 microg/mL, respectively). Minimal/no injuries were observed in group 3; enzymes were normalized (ALT 89 +/- 9 microg/mL and AST 150 +/- 17 microg/mL), and tissue edema was similar to sham.
conclusionsCR from HS restored and maintained central hemodynamics but did not restore or maintain liver perfusion and was associated with significant hepatocellular injury and dysfunction. DPR added to conventional resuscitation (blood and crystalloid) restored and maintained liver perfusion, prevented hepatocellular injury and edema, and preserved liver function.
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