A comparison of vasopressin, terlipressin, and lactated ringers for resuscitation of uncontrolled hemorrhagic shock in an animal model

Chien-Chang Lee; Meng-Tse Gabriel Lee; Shy-Shin Chang; Si-Huei Lee; Yu-Chi Huang; Chia-Hung Yo; Shih-Hao Lee; Shyr-Chyr Chen

doi:10.1371/journal.pone.0095821

A comparison of vasopressin, terlipressin, and lactated ringers for resuscitation of uncontrolled hemorrhagic shock in an animal model

PLoS One. 2014 Apr 23;9(4):e95821. doi: 10.1371/journal.pone.0095821. eCollection 2014.

Authors

Chien-Chang Lee¹, Meng-Tse Gabriel Lee¹, Shy-Shin Chang², Si-Huei Lee³, Yu-Chi Huang¹, Chia-Hung Yo⁴, Shih-Hao Lee¹, Shyr-Chyr Chen¹

Affiliations

¹ Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
² Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Family Medicine and Emergency Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
³ Department of Rehabilitation and Physical Medicine, National Yang-Ming University and Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
⁴ Department of Emergency Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.

Abstract

Aim: The aim of this study is to compare the effect of lactated ringer (LR), vasopressin (Vaso) or terlipressin (Terli) on uncontrolled hemorrhagic shock (UHS) in rats.

Methods: 48 rats were divided into four treatment groups for UHS study. Vaso group was given bolus vasopressin (0.8 U/kg); the Terli group was given bolus terlipressin (15 mcg/kg); LR group was given LR and the sham group was not given anything. Mean arterial pressure (MAP), serum lactate level, plasma cytokine levels, lung injury and mortality are investigated for these different treatment groups.

Results: Compared with LR group, vasopressin and terlipressin-treated groups were associated with higher MAP, lowered mortality rates, less lung injury, lowered serum lactate level, less proinflammatory and more anti-inflammatory cytokine production at certain time points. Comparing between vasopressin and terlipressin treated groups, there is no statistical difference in mortality rates, lung injury, serum lactate level and cytokine level. However, there is a difference in the length of time in maintaining a restored level of MAP (80 to 110 mmHg). The terlipressin treated rats can maintain this restored level of MAP for 45 minutes, but the vasopressin treated rats can only maintain this restored level of MAP for 5 minutes before decreasing gradually to the MAP observed in LR group (40 mmHg).

Conclusion: Early optimization of hemodynamics with terlipressin or vasopressin in an animal model of UHS was associated with improved hemodynamics and inflammatory cytokine profile than the LR control. Compared with vasopressin, terlipressin has the advantage of ease of use and sustained effects.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Disease Models, Animal
Isotonic Solutions / therapeutic use*
Lypressin / analogs & derivatives*
Lypressin / therapeutic use
Male
Rats
Rats, Wistar
Ringer's Lactate
Shock, Hemorrhagic / drug therapy*
Terlipressin
Vasopressins / therapeutic use*

Substances

Isotonic Solutions
Ringer's Lactate
Vasopressins
Lypressin
Terlipressin

Grants and funding

This study was supported by the National Science Council Grant NSC 96-2314-B-002-042 and National Taiwan University Hospital Grant NTUH96N01. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.