Hypertonic saline and hemorrhagic shock: hepatocellular function and integrity after six hours of treatment1 Solução salina hipertônica e choque hemorrágico: função hepatocelular e integridade após seis horas de tratamento

Purpose: The comparison after 6h of hemorrhagic shock (HS) treatment with NaCl 7.5% (Hypertonic Saline Solution – SSH) or Ringer Lactate (RL) on liver function and integrity. Methods: Male Wistar rats were submitted to HS (Mean Arterial Pressure – MAP= 45 mmHg) during 60 min and then treated with NaCl 7.5% (SSH, 10% of blood loss, n=8) or Ringer Lactate (RL, 400% of blood loss, n=8). After 6h rats were anesthetized, hepatic function was assessed by bile flow measurement and liver integrity evaluated by determination of alanine aminotransferase (ALT) and bilirubin activities. Results: There was no difference in MAP between the groups during the whole experiments. Biliary flow showed a significant recovery after SSH treatment (p<0.05), and significant decrease of ALT (p<0.001) and bilirubin levels (p<0.001) in comparison to RL. Conclusion: Resuscitation of HS with NaCl 7.5% promoted better recovery of liver function and lesser hepatocellular damage after 6h of treatment compared to RL. The improvement is very likely related to increased microvascular perfusion provided by small volume resuscitation.