Global longitudinal strain changes during hemorrhagic shock: An experimental study

Laurent Zieleskiewicz; Pierre-Géraud Claret2; 3; Laurent Muller2; 3; Jean Emmanuel de La Coussaye2; 3; Jean Yves Lefrant2; 3; Iris Schuster; Claire Roger2; 3; Xavier Bobbia2; 3*

Laurent Zieleskiewicz¹, Pierre-Géraud Claret^2,3, Laurent Muller^2,3, Jean Emmanuel de La Coussaye^2,3, Jean Yves Lefrant^2,3, Iris Schuster⁴, Claire Roger^2,3, Xavier Bobbia^2,3*

Keywords: Hypovolemia, strain, systolic function

Abstract

OBJECTIVES: Global longitudinal strain (GLS) appears sensitive and reproducible to identify left ventricular systolic dysfunction. The main objective was to analyze the GLS changes in an anesthetized-piglet model of controlled hemorrhagic shock (HS). The secondary objective was to evaluate if GLS changes was different depending on the expansion fluid treatment with or without norepinephrine.

METHODS: Eighteen anesthetized and ventilated piglets were bled until the mean arterial pressure reached 40 mmHg. Controlled hemorrhage was maintained for 30 min before randomizing the piglets to three resuscitation groups: control group, LR group (resuscitated with lactated ringer), and NA group (resuscitated with lactated ringer and norepinephrine).

RESULTS: There was no difference in the baseline hemodynamic, biological, and ultrasound data among the three groups. During the hemorrhagic phase, the GLS increased significantly from 25 mL/kg of depletion. During the resuscitation phase, the GLS decreased significantly from 20 mL/ kg of fluid administration. There was no difference in GLS variation among the groups during the hemorrhagic, maintenance, and resuscitation phases.

CONCLUSION: In our HS model, GLS increased with hemorrhage and decreased during resuscitation, showing its preload dependence.

How to cite this article: Zieleskiewicz L, Claret PG, Muller L, La Coussaye JE, Lefrant JY, Schuster I, et al. Global longitudinal strain changes during hemorrhagic shock: An experimental study. Turk J Emerg Med 2020;20:97-104.

Ethics Committee Approval

The Animal Care and Use Committee of Languedoc-Roussillon (CEEA- LR-12013) approved the protocol and all experiments were performed in an authorized animal research laboratory. This animal study was conducted according to the European Directive 2010/63/EC regulating the use of animals in science.

Author Contributions

TM, LZ, LM, CR, and XB conceived and designed the experiments; TM, CR, and XB performed the experiments; TM, LZ, PGC, LM, and XB analyzed and interpreted the data; TM and XB contributed reagents, materials, analysis tools, or data; TM, LZ, PGC, JELC, LM, JYL, CR, and XB wrote the paper.

Conflict of Interest

XB declares a competing interest as a US teacher for GE (GE MEDICAL SYSTEMS ULTRASOUND) customers. The other authors state they have no competing interests.

Financial Disclosure

None declared.

Acknowledgments

The authors acknowledge Marylene Peltier for her help in administrative, technical, and logistical support, Nadege Magnan for her help in administrative support, and Marc Giet and Jack Fountain for the preparation of the animals and for their technical assistance.