PLASMA RESUSCITATION WITH ADJUNCTIVE PERITONEAL RESUSCITATION REDUCES ISCHEMIC INTESTINAL INJURY FOLLOWING HEMORRHAGIC SHOCK

INTRODUCTION Impaired intestinal microvascular perfusion following resuscitated hemorrhagic shock (HS/RES) leads to ischemia-reperfusion injury, microvascular dysfunction and intestinal epithelial injury, which contribute to the development of multiple organ dysfunction syndrome in some trauma patients. Restoration of central hemodynamics with traditional methods alone often fails to fully restore microvascular perfusion and does not protect against ischemia-reperfusion injury. We hypothesized that resuscitation with fresh frozen plasma (FFP) alone or combined with direct peritoneal resuscitation (DPR) with 2.5%Delflex solution might improve blood flow and decrease intestinal injury compared to conventional resuscitation or resuscitation with DPR alone. METHODS Sprague Dawley rats underwent HS (40% mean arterial pressure) for 60 minutes and were randomly assigned to a resuscitation group (n=8): Sham; HS+crystalloid resuscitation(CR) (shed blood+two volumes CR); HS+CR+DPR (intraperitoneal 2.5% peritoneal dialysis fluid (IP)); HS+FFP (shed blood+two volumes FFP); HS+DPR+FFP (IP dialysis fluid+two volumes FFP). Laser Doppler Flowmeter evaluation of the ileum, serum samples for FABP ELISAs, and HE combination FFP+DPR therapy alleviated most signs of organ injury. Resuscitation with FFP+DPR to restore intestinal blood flow following shock could be an essential method of reducing morbidity and mortality after trauma.Basic Science/NA.