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Advisor(s)
Abstract(s)
Introduction: severe hemorrhage remains the major cause of morbidity and mortality in trauma victims or surgical intervened animals, despite of all the advances in the therapeutic approach. The resulting injuries, or even death, are due to the deficit in intravascular volume and subsequent development of hypovolaemic fluid state, leading to poor tissue perfusion and consequent decreased oxygen delivery to the tissues, often with compromise of organ function.
Objective: the aim of this work was to evaluate the effect of different intravenous solutions used for volume replacement following acute controlled haemorrhage, one crystalloid (RL) and one colloid (HES130/0.4) in the integrity of the hepatic tissue in a pig animal model.
Material and methods: hepatic samples were collected from animals submitted to passive arterial blood bleeding and reperfusion with a crystalloid (RL) (G1) and with a synthetic colloid (HES 130/0.4) (G2). Samples were also collected from animals that were not subjected to acute bleeding nor volume replacement (G3, control group). All procedures were carried out under personal and project licenses approved by the Ethical Committee of the national regulatory office. Samples were collected and fixed in 10% neutral-buffered formalin, for a maximum of 24hours, embedded in paraffin wax and 3µm sections were stained for routine histopathology with haematoxylin and eosin.
Results: the histopathological assessment revealed no statistically significant differences between the three groups. However, some lesions were more often expressed in some groups. More severe hepatocellular hydropic degeneration and hepatocellular steatosis was seen in G1, which is the only group in which haemorrhage was observed and within which oedema was not present. Hyperaemia was only observed in G2 and G3. Necrosis was not present in any of the groups.
Conclusion: hepatic histopathological lesions following controlled bleeding and intravenous volume replacement with RL or HES130/0.4 were subtle. However, more pronounced hydropic degeneration and hepatocellular steatosis was seen in G1 (RL), which suggests that HES130/04 may be associated with better hepatic perfusion when used for intravenous volume replacement when compared to RL.
Description
Keywords
Hepatic histopathological lesions Acute controled haemorrhage Colloid solution Crystalloid solution Volume replacement
Pedagogical Context
Citation
Vala, H., Pina, R., Cruz, R., Venancio, C., Esteves, F., Silva, A., ... Ferreira, D. (Agosto/Setembro, 2017). Hepatic histopathological lesions in acute controled haemorrhage followed by volume replacement with a crystalloid or colloid solution (pp. 67-68). In Abstract book of the Cutting Edge Pathology, 3rd Joint European Congress of the ESVP, ESTP and ECVP, Lyon, France.