Resuscitation with lactated Ringer's solution in rats with hemorrhagic shock induces immediate apoptosis

Background: We hypothesize that different resuscitative fluids may immediat ely affect the degree of apoptosis after hemorrhagic shock, Methods: Rats (n = 35) were hemorrhaged 27 mL/kg over 5 minutes followed by 1 hour of shock, then resuscitation over I hour. The sis treatment groups were sham hemorrhage, sham resuscitation, whole blood resuscitation, lactat ed Ringer's solution (LR) resuscitation with three times the volume bled, s ham hemorrhage with LR infusion, and 7.5% hypertonic saline resuscitation ( 9.7 mL/kg), Liver and small intestine were harvested immediately after resu scitation, Apoptosis was evaluated by using in situ cell death detection me thod. Results: Resuscitation with LR resulted in a significant increase in small intestinal and liver apoptosis, Animals that received LR infusion without h emorrhage had an increased level of apoptosis in the intestine, Apoptosis i n the intestine was observed in both the mucosa and muscularis externa, The re was no increase in apoptosis in either organ in the animals resuscitated with sham resuscitation, whole blood, and hypertonic saline compared with the sham hemorrhage group. Conclusion: Resuscitation with LR solution after hemorrhagic shock increase d immediate cell death by apoptosis in both the small intestine and liver. There was no significant increase in apoptosis in the animal resuscitated w ith hypertonic saline, whole blood, or in unresuscitated animals. Thus, the type of resuscitation fluid used may affect the apoptotic cellular respons e to shock.