{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:23:59Z","timestamp":1789712639717,"version":"4.0.1"},"reference-count":36,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2016,8,30]]},"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In hemorrhagic shock (HS), volume replacement with crystalloid solution can restore the hemodynamic status and decrease mortality. However, it can also lead to tissue edema and pulmonary congestion, as well as increasing vascular permeability. Here, we analyzed the effects that resuscitation with lactated Ringer's solution (LRS) or administration of the vasopressin analog terlipressin has on renal function in a porcine model of HS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using pressure-controlled bleeding, we induced pigs to HS, maintaining mean arterial pressure (MAP) at 40\u2005mm\u2005Hg for 30\u2005min. Animals were divided into 4 groups: sham (anesthesia only); shock-only (HS induction); shock+LRS (HS induction and subsequent resuscitation with LRS at 3 times the volume of blood removed); and shock+Terli (HS induction and subsequent bolus administration of 2\u2005mg of terlipressin). Parameters were evaluated at baseline, then at 30, 60, and 120\u2005min after treatment (T30, T60, and T120, respectively). Animals were euthanized at T60 or T120.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Both treatments restored MAP to baseline values. At T30 and T60, creatinine clearance was highest in shock+LRS pigs, whereas it was highest in shock+Terli pigs at T120. Both treatments initially induced hyponatremia, although urinary excretion of all ions was higher in shock+LRS pigs at T30. Both treatments restored Na\u2013K\u20132Cl cotransporter expression, whereas only terlipressin restored aquaporin 2 expression. Both treatments also prevented HS-induced acute tubular necrosis. Expression of the vasopressin receptors V1a and V2 was highest in shock-only pigs. At T120, V1a expression was lowest in shock+LRS pigs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Terlipressin might be useful for preventing HS-induced acute kidney injury.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2016-000039","type":"journal-article","created":{"date-parts":[[2016,9,27]],"date-time":"2016-09-27T14:24:42Z","timestamp":1474986282000},"page":"e000039","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Vasopressin analog terlipressin attenuates kidney injury in hemorrhagic shock"],"prefix":"10.1136","volume":"1","author":[{"given":"Let\u00edcia Urbano","family":"Cardoso de Castro","sequence":"first","affiliation":[{"name":"Division of Nephrology, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keila Kazue","family":"Ida","sequence":"additional","affiliation":[{"name":"Anesthesiology Department, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise Aya","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Anesthesiology Department, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talita Rojas","family":"Sanches","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rildo A","family":"Volpini","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilyn da Silva","family":"Borges","sequence":"additional","affiliation":[{"name":"Anesthesiology Department, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz-Marcelo S\u00e1","family":"Malbouisson","sequence":"additional","affiliation":[{"name":"Anesthesiology Department, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00facia","family":"Andrade","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of S\u00e3o Paulo School of Medicine, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,9,26]]},"reference":[{"key":"2025082410141220000_1.1.e000039.1","unstructured":"Sociedade Brasileira de Atendimento Integrado ao Traumatizado, O que \u00e9 Trauma? 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