COMPARATIVE EFFECTS OF CRYSTALLOID AND SMALL-VOLUME HYPERTONIC HYPERONCOTIC FLUID RESUSCITATION ON HEPATIC MICROCIRCULATION AFTER HEMORRHAGIC-SHOCK

Hepatic microcirculation, leukocyte-endothelial interaction, and sinus oidal widths were studied by means of intravital microscopy in a non-h eparinized fixed pressure hemorrhagic shock model in the rat. Asanguin eous resuscitation was performed either with ''adequate'' amounts of l actated Ringer's solution (threefold shed volume/30 min) or 4 ml/kg/3 min 7.2% saline/10% Dextran 60 (HSDex) or 4 ml/kg/3 min 7.2% saline/10 % hydroxyethylstarch 200/0.62 (HSHes). Hemorrhagic shock and resuscita tion was paralleled by significant (P < 0.01) lumenal narrowing of sin usoids that remained largely uninfluenced by the type of fluid used fo r resuscitation (HSDex: 9.28 +/- 0.56; HSHes: 8.93 +/- 0.29, LR: 8.87 +/- 0.6 mum compared to 12.17 +/- 0.24 mum in controls). Whereas HSHes and LR-therapy resulted in comparably increased leukocyte adhesion to the sinusoidal wall, the dextran-containing solution led to a signifi cant attenuation of leukocyte-endothelial interaction, suggesting invo lvement of dextran-binding adhesion molecules, e.g., selectins. (C) 19 93 Wiley-Liss, Inc.