IntroductionInflammation plays a major role in the multifactorial process of trauma associated coagulopathy. The vagus nerve regulates the cholinergic anti-inflammatory pathway.
We hypothesized that efferent vagus nerve stimulation (VNS) can improve coagulopathy by modulating the inflammatory response to hemorrhage.
Methods:
Wistar rats (n = 24) were divided in 3 groups: Group (G1) Sham hemorrhagic shock (HS); (G2) HS w/o VNS; (G3) HS followed by division of the vagus nerves and VNS of the distal stumps. Hemorrhage (45% of baseline MAPx15 minutes) was followed by normotensive resuscitation with LR.
Vagus nerves were stimulated (3.5 mA, 5Hz) for 30 sec 7 times. Samples were obtained at baseline and at 60 minutes for thromboelastometry (Rotem(R)) and cytokine assays (IL-1 and IL-10).
ANOVA was used for statistical analysis; significance was set at p
Results:
Maximum clot firmness (MCF) significantly decreased in G2 after HS (71.5 +/- 1.5 vs. 64 +/- 1.6) (p
MCF significantly increased in G3 compared to baseline (67.3 +/- 2.7 vs. 71.5 +/- 1.2) (p
G3 also showed significant improvement in Alfa angle, and Clot Formation Time (CFT) compared to baseline. IL-1 increased significantly in group 2 and decrease in group 3, while IL-10 increased in group 3 (p
Conclusions:
Electrical stimulation of efferent vagus nerves, during resuscitation (G3), decreases inflammatory response to hemorrhage and improves coagulation.
Author: Joao B Rezende-NetoRoger Lage AlvesMario CarvalhoThiago AlmeidaCyntia TrantChristopher KushmerickMarcus AndradeSandro B RizoliJose Cunha-Melo
Credits/Source: Journal of Trauma Management Outcomes 2014, 8:15
Published on: 2014-09-17
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