Hydroxyethyl starch normalizes platelet and leukocyte adhesion within pulmonary microcirculation during LPS-induced endotoxemia

被引:18
作者
Kuepper, Sebastian
Mees, Soeren Torge [1 ]
Gassmann, Peter
Brodde, Martin F.
Kehrel, Beate
Haier, Joerg
机构
[1] Univ Hosp Munster, Mol Biol Lab, Dept Gen Surg, Munster, Germany
[2] Univ Hosp Munster, Dept Anesthesiol & Intens Care, Munster, Germany
来源
SHOCK | 2007年 / 28卷 / 03期
关键词
endotoxemia; LPS; platelets; leukocytes; intravital microscopy; pulmonary; microcirculation;
D O I
10.1097/shk.0b013e3180340664
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
G rowing evidence supports substantial pathophysiological impact of platelets and their interactions on the development of septic lung failure. We developed a rat model of endotoxemia for direct in situ visualization of pulmonary microcirculation by in vivo fluorescence videomicroscopy. Male Sprague-Dawley rats were assigned to control, enclotoxemia (Escherichia coli LPS, 15 mg/kg, i.v..), and fluid management for treatment of LPS-induced hypovolemia (Ringer lactate, hydroxyethyl starch [HES] 6%) groups (n = 7 each). Leukocytes were labeled in vivo by rhodamine, and 5 x 106 Calcein-AM-labeled nonactivated platelets were injected. Microcirculatory parameters (vessel diameter, ventilation-perfusion ratio) and adhesive characteristics of platelets and leukocytes (velocity, rolling, sticking) within the pulmonary microcirculation were quantified after endotoxin application under various regimens of fluid substitution for 60 min. A reduction of cell velocity and enhanced cell adhesion was seen in leukocytes and platelets (P < 0.05) after LPS injection. Fluid treatment with HES 6% resulted in a significant increase of platelet's velocity compared with the LPS group (442.86 +/- 20.60 vs. 343.93 +/- 11.17; P < 0.05), whereas Ringer lactate showed no beneficial effects. Similarly, HES 6% normalized LPS-induced platelet rolling and sticking as well as alterations in ventilation-perfusion ratio. Using direct visualization of the pulmonary microcirculation, we observed that platelet and leukocyte interactions are enhanced in the lung during LPS endotoxemia. Fluid therapy with HES 6% seems to have restorative effects on these cellular functions within the pulmonary microcirculation.
引用
收藏
页码:300 / 308
页数:9
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