Antioxidative resuscitation solution prevents leukocyte adhesion in the liver after hemorrhagic shock

Background: The generation of iron-dependent toxic oxygen radicals during t he initial resuscitation from hemorrhagic shock was shown to be a relevant factor for the initiation of the inflammatory cascade, Therefore, this expe rimental study was designed to evaluate the effects of a deferoxamine-conju gated hydroxyethyl-starch solution (HES-DFO) on oxygen radical induced inju ry and microcirculatory alterations in the rat liver compared with resuscit ation with regular hydroxyethyl-starch, lactated Ringer's solution (RL), or a gelatin-based solution, Methods: After hemorrhage and random assignment to 1 hour of blood-free res uscitation with the aforementioned solutions, hepatic microcirculation and leukocyte adhesion characteristics were assessed by intravital fluorescence microscopy in anesthetized rats, Oxygen radical activity was estimated by determination of glutathione levels in liver homogenate and determination o f thiobarbituric acid-reactive substances in plasma as markers of lipid per oxidation, Results: Resuscitation by HES-DFO resulted in restoration of hemodynamic pa rameters compared with gelatin-based solution and HES, The hepatic microcir culation was severely altered 1 hour after resuscitation from shock in all groups indicated by sinusoidal narrowing and reduced sinusoidal blood flow. HES-DFO, however, attenuated leukocyte adhesion and improved velocity inde x in sinusoids as well as sinusoidal perfusion, The shock-associated genera tion of oxygen radicals during resuscitation was prevented by HES-DFO as in dicated by restored glutathione and reduced thiobarbituric acid-reactive su bstances, Conclusion: The results suggest that HES-DFO effectively reduces oxygen rad ical formation during the initial resuscitation period, thus, attenuating p athologically enhanced leukocyte adhesion and improving hepatic microcircul ation.