The effect of blood substitute and stored blood for multiple organ dysfunction following hemorrhagic shock

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1. Identification of inflammatory mediators in mesenteric lymph following hemorrhagic shockWe found six inflammatory mediators, tumor necrosis factor, cytokine-induced neutrophil chemoattractant-1, linoleic lyso-phosphatidylethanolamine (LPE), linoleic lyso-phosphatidylcholine (LPC), arachidonic LPE, and arachidonic LPC, in mesenteric lymph following hemorrhagic shock.2. Analysis of biological activities of lipid mediators identified in mesenteric lymphWe evaluated biological activities for human neutrophils (superoxide production, elastase release, and transmigration) of lyso-phospholipids which we discovered in mesenteric lymph. Four lyso-phospholipids induced biological activities to human neutrophils in dose-dependent manner. This was the first report of the presence of inflammatory mediators in mesenteric lymph. It is expected that elucidation of the site and mechanism of production links to the strategies for multiple organ failure (MOF) after hemorrhagic shock.3. Biological acti … More vity of mesenteric lymph after transfusion of stored blood for hemorrhagic shockWe measured the biological activity (superoxide production of human neutrophil) of mesenteric lymph from rats transfused with stored blood. Compared to rats transfused with fresh blood, mesenteric lymph in stored blood group significantly increased superoxide production. On the other hand, Mesenteric lymph from rats transfused with blood substitute induced the significant decrease in superoxide production. Consequently, it is possible that blood substitute attenuates lung injury and systemic inflammatory response syndrome following hemorrhagic shock.4. The effect of blood substitute on the intestinal oxygen metabolism after hemorrhagic shockTo evaluate the effect of blood substitute on the intestinal oxygen metabolism, we measured lactate and alanine, as a maker of tissue oxygen metabolism, in the intestine exposed to hemorrhagic shock with nuclear magnetic resonance spectroscopy. Blood substitute improved the intestinal oxygen metabolism equal to fresh blood. Previous studies reported that stored blood was associated with the intestinal ischemia and MOF. Therefore, blood substitute may be one of strategy for MOF. Less