Effects of blood volume restitution following a portal hypertensive-related bleeding in anesthetized cirrhotic rats

The aim of this study was to investigate the influence of different strateg ies of blood volume restitution in the outcome of portal hypertension-relat ed bleeding in anesthetized cirrhotic rats. Gastrointestinal hemorrhage was induced by sectioning a first order branch of the ileocolic vein in 38 cir rhotic rats (common bile duct ligation and occlusion). The subsequent hypov olemic shock was treated with no transfusion (n = 17), moderate transfusion (50% of expected blood loss, 5 mL, n = 11), and total transfusion (100% of expected blood loss, 10 mL, n = 10), At the end of the blood transfusion p eriod (minute 15), mean arterial pressure (MAP) partially recovered in rats receiving moderate transfusion or no transfusion but decreased in the 10-m L transfusion group (down arrow 12 +/- 43%, P < .05 vs. no transfusion and 5 mL transfusion). After transfusion, groups given no or 5 mL transfusion r emained hemodynamically stable. However, rats receiving 10 mL transfusion c ontinued to deteriorate with persistent bleeding and progressive fall in MA P (<down arrow> 65 +/- 12%; P < .05 vs. no transfusion and 5 mt transfusion ), Collected blood loss was significantly greater in the 10-mL group (20.0 +/- 1.5 g) than in groups given 5 mL (15.9 +/- 2.8 g; P < .05) or no transf usion (13.2 +/- 2.1 g; P < .05 vs. 10 mL and 5 mL transfusion). Survival in the no transfusion group was 47%. Rats given 5-mL transfusion had 64% surv ival, The worst survival was observed in the 10-mL transfusion group (0% su rvival; P < .05), We concluded that a transfusion policy aimed at completel y replacing blood loss worsens the magnitude of bleeding and mortality from portal hypertensive-related bleeding in cirrhotic rats. On the contrary, m oderate blood transfusion allowed hemodynamic stabilization and increased s urvival.