Preinjury fed state alters the physiologic response in a porcine model of Hemorrhagic Shock and Polytrauma

Kristin P. Colling, Uroghupatei P. Iyegha, Javariah I. Asghar, Daniel R. Lexcen, Elizabeth R. Lusczek, Charles E. Determan, Nancy E. Witowski, Kristine E. Mulier, Greg J. Beilman

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Introduction: Hemorrhagic shock and injury lead to dramatic changes in metabolic demands and continue to be a leading cause of death. We hypothesized that altering the preinjury metabolic state with a carbohydrate load prior to injury would affect subsequent metabolic responses to injury and lead to improved survival. Methods: Sixty-four pigs were randomized to fasted (F) or carbohydrate prefeeding (CPF) groups and fasted 12 h prior to experiment. The CPF pigs received an oral carbohydrate load 1 h prior to anesthesia. All pigs underwent a standardized injury/hemorrhagic shock protocol. Physiologic parameters and laboratory values were obtained at set time points. Results: Carbohydrate prefeeding did not convey a survival benefit; instead, CPF animals had greater mortality rates (47% vs. 28%; P = 0.153; log-rank [Mantel-Cox]). Carbohydrate prefeeding animals also had higher rates of acute lung injury (odds ratio, 4.23; 95% confidence interval, 1.1-16.3) and altered oxygen utilization. Prior to shock and throughout resuscitation, CPF animals had significantly higher serum glucose levels than did the F animals. Conclusions: Carbohydrate prefeeding did not provide a survival benefit to swine subjected to hemorrhagic shock and polytrauma. Carbohydrate prefeeding led to significantly different metabolic profile than in fasted animals, and prefeeding led to a greater incidence of lung injury, increased multiorgan dysfunction, and altered oxygen utilization.

Original languageEnglish (US)
Pages (from-to)103-113
Number of pages11
JournalShock
Volume44
DOIs
StatePublished - Aug 2015

Keywords

  • Acute lung injury
  • Glucose
  • Hemorrhagic shock
  • Hyperglycemia
  • Porcine model
  • Preconditioning
  • Trauma

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