Efficacy of leukocyte-depleted blood and plasma substitute mixed with RBCs in the treatment of hemorrhagic shock in dogs

Objective To evaluate the efficacy of leukocyte-depleted blood and 6% hydroxyethyl starch (HES) mixed with RBCs in the treatment of hemorrhagic shock and their effects on the systemic inflammatory response. Methods Twenty-four healthy dogs of both sexes weighing 15-20 kg were randomized into 4 groups ( n = 6 each): A HES; B whole blood; C leukocyte-depleted blood and D RBC-HES. Hemorrhagic shock was produced according to Wigger's method. MAP was maintained at 40 mm Hg for 60 min by blood removal. Subsequently the dogs were resuscitated with 6% HES or whole blood or leukocyte-depleted blood or RBC-6% HES. MAP, HR and cardiac output (CO) were monitored and recorded. Venous blood samples were taken for determination of plasma concentrations of MDA, IL-1β, endothelin (ET) ,TNF-α, platelet activating factor (PAF) and neutrophil CD11b expression immediately before shock (T1, baseline) at the end of 60 min shock (T2) and at 60 min of resuscitation (T3). Results MAP and CO were significantly decreased whereas HR was significantly increased during shock (T2) in all 4 groups. Plasma concentrations of MDA, IL-1β, TNF-α, ET, PAF and neutrophil CD11b expression were significantly increased during shock at T2 and returning to pre-shock baseline level during resuscitation at T3 in all 4 groups especially in group C and D. Conclusion Both leukocyte-depleted blood and RBC-HES mixture have satisfactory anti-hemorrhagic shock effect and can attenuate the systemic inflammatory response induced by hemorrhagic shock.