Relationship between TNF-α and uncontrolled hemorrhagic shock and effects of different fluid resuscitation

Objective To investigate the effects of limited fluid resuscitation in the model of uncontrolled hemorrhagic shock and the relationship between the serum TNF-α concentration and uncontrolled hemorrhagic shock.Methods Rat models of uncontrolled hemorrhagic shock were established using the modified Krausz method.Forty rats were randomly divided into 4 groups: sham-operated group,limited fluid resuscitation group,conventional fluid resuscitation group and no fluid resuscitation group.Results ①The blood loss and the amount of fluid resuscitation in limited fluid resuscitation group was significantly lower than that in conventional group(P0.05).②The Hct of the limited fluid resuscitation group was higher than the conventional group(P0.05).③The survival time of the limited fluid resuscitation group was longer than that of conventional fluid resuscitation group or that of no fluid resuscitation group(P0.05).The 72 h survival rate in limited fluid resuscitation group was higher than that in conventional fluid resuscitation group or that in no fluid resuscitation group(P0.10).④The serum TNF-α concentration increased in all groups except sham-operated group after massive splenic injury(P0.05).The TNF-α concentration in conventional fluid resuscitation group was higher than that in the limited fluid resuscitation group(P0.05).⑤The serum TNF-α concentration of the dead was higher than that of the survival(P0.05).Conclusion The results of our study demonstrate that the limited resuscitation during uncontrolled hemorrhage could raise survival rate and prolong survival time.The poor prognosis of uncontrolled hemorrhage was associated with higher serum TNFα concentration,which could be lowered by the limited resuscitation.