Impact of shock and fluid resuscitation on the morphology and apoptosis of bone marrow: An experimental study

José Gustavo Parreira, Samir Rasslan, Luiz F. Poli De Figueiredo, Thereza Christina Bortolheiro, Sueli Sinosaki, Daniela Hardt, Margareth Yada Langui, Milene N. Rocha, Carlos Alberto Longui, Carlos Chiattone, Maurício Rocha E Silva, Andrew B. Peitzman, Peter Rhee, Rao R. Ivatury

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: We hypothesized that bone marrow failure after hemorrhagic shock might be secondary to impaired apoptosis regulation. Our objective was to assess the morphologic alterations and the rate of apoptosis in bone marrow after hemorrhagic shock and resuscitation. Methods: Under pentobarbital anesthesia, Wistar rats (n = 70) underwent femoral vessel cannulation. The hemorrhagic shock model involved a controlled retrieval of blood, maintaining mean blood pressure at 40 ± 5 mm Hg during 50 minutes. During the resuscitation period, lactated Ringer's (twice the blood volume retrieved, group LR) or NaCl 7.5% (4 μL/kg, group HS) was infused followed by the previously retrieved blood. Bone marrow was collected through left femoral puncture. Morphology was assessed by Leishmann-stained smears, and apoptosis was assessed through terminal deoxynucleotide transferase-mediated DUTP nick-end labeling assay. Analysis of variance and Tukey's test were applied for statistical treatment, considering p < 0.05 as significant. Results: LR animals presented a statistically significant decrease in the lymphocytic series (LR, 24.2 ± 4.2%; Sham, 55.1 ± 6.6%), together with an increase in the percentage of granulocyte (LR, 51.4% ± 2.3%; Sham, 31.5 ± 2.9%) and monocyte precursors (LR, 7.3 ± 1.3%; Sham, 3.3 ± 1.1%), detected 72 hours after shock (p < 0.05). Both LR and HS groups presented a significant increase in apoptosis, when compared with the sham group (LR, 13.1 ± 0.5%; HS, 12.2; 0.7%; Sham, 6.8 ± 0.4%). The alterations detected in the bone marrow morphology of LR group were not observed in HS animals. Conclusion: There was an increase in bone arrow apoptosis after hemorrhagic shock. The type of resuscitation scheme used did influence bone marrow morphology.

Original languageEnglish (US)
Pages (from-to)1001-1008
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number5
StatePublished - May 2004
Externally publishedYes


  • Apoptosis
  • Bone marrow
  • Fluid resuscitation
  • Hemorrhagic shock
  • Hypertonic saline
  • Lactated Ringer's

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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