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Critical Care

Open Access

Bone marrow cellularity after hemorrhagic shock and fluid resuscitation with hypertonic saline or lactated Ringer's solution

  • CJ Correia1,
  • JG Parreira1,
  • P Borelli1,
  • LF Poli de Figueiredo1,
  • S Sinosaki1 and
  • M Rocha e Silva1
Critical Care20059(Suppl 2):P45

https://doi.org/10.1186/cc3589

Published: 9 June 2005

Keywords

Mean Arterial PressureHemorrhagic ShockHypertonic SalineFluid ResuscitationLactate Ringer

Introduction

Qualitative alterations in the bone marrow morphology have been described after shock and fluid resuscitation. However, quantitative cellularity must also be addressed.

Objective

To assess bone marrow cellularity after hemorrhagic shock and fluid resuscitation with hypertonic saline (HSS) and lactated Ringer's solution (LR).

Methods

Wistar rats (250–300 g, n = 22), anesthetized with pentobarbital, were bled to a mean arterial pressure (MAP) of ± 40 mmHg over 10 min and were maintained at this level for 50 min. The animals were randomized into four groups: Sham (cannulation, no shock, no treatment), NT (shock, no treatment), LR (shock, followed by the infusion of LR, 3 × shed blood volume), and HSS (shock, followed by the infusion of 7.5% NaCl, 4 ml/kg). The shed blood was not reinfused. Animals were killed 72 hours after shock; the marrow cavity of the femur was washed with McCoy's Medium (2 ml), and total and differential leukocyte counts were performed in the perfusate. Blood samples for total and differential blood leukocyte counts were obtained from the cut tip of the tail of the animals.

Results

Resuscitation with LR and HSS restored the MAP to the basal levels. Table 1 presents the bone marrow counts. There was no difference among groups concerning leukocyte blood counts.

Table 1

 

Sham (× 107/ml)

NT (× 107/ml)

LR (× 107/ml)

HSS (× 107/ml)

Total

4.1 ± 0.8

3.5 ± 1.2

2.6 ± 0.2*

4.9 ± 0.7

Blasts

0.07 ± 0.03

0.07 ± 0.03

0.03 ± 0.008

0.06 ± 0.02

Neutrophils

2.0 ± 0.4

1.7 ± 0.2

0.9 ± 0.01*

2.0 ± 0.3

Eosinophils

0.3 ± 0.1

0.3 ± 0.1

0.2 ± 0.009*

0.5 ± 0.1

Lymphoid

0.3 ± 0.1

0.5 ± 0.1

0.3 ± 0.05

0.3 ± 0.06

Erythroblast

1.3 ± 0.3

1.5 ± 0.2

0.9 ± 0.1*

2.0 ± 0.5

G/E relation

2.29 ± 0.78

1.32 ± 0.13

1.44 ± 0.33

1.51 ± 0.40

Hematocrit

47% ± 0.9

33% ± 0.9

36% ± 1.4

35% ± 0.7

* P < 0.05 (LR vs HSS), Mann–Whitney test.

Conclusion

After hemorrhagic shock, the bone marrow total cellularity decreased both in animals resuscitated with LR and in those not resuscitated with fluids. After resuscitation with LR, the number of myeloid and erythroblast cells was lower than that observed in the resuscitation with HSS.

Declarations

Acknowledgements

Supported by FAPESP and PRONEX.

Authors’ Affiliations

(1)
Santa Casa Medical School, Faculty of Pharmaceutica Sciences of the University of São Paulo, Research Division, Heart Institute (InCor), University of São Paulo Medical School, Brazil

Copyright

© BioMed Central Ltd 2005

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