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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2001 April;67(4):190-2

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Ringer’s ethyl pyruvate solution: a novel resuscitation fluid

Fink M. P.

From the University of Pittsburgh Medical Center Watson Professor of Surgery Chief, Division of Critical Care Medicine Professor of Anesthesiology and Critical Care Medicine Pittsburgh, USA


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Reac­tive oxy­gen spe­cies (ROS) ­have ­been impli­cat­ed in the path­o­gen­e­sis of the struc­tu­ral and func­tion­al alter­a­tions to tis­sues ­that are asso­ciat­ed ­with a varie­ty of path­o­log­i­cal pro­cess­es, includ­ing: sep­sis and sep­tic ­shock, ther­mal inju­ry, dox­i­ru­bi­cin-­induced car­di­om­yo­pa­thy, hemor­rhag­ic ­shock, and mes­en­ter­ic ische­mia/reper­fu­sion (I/R) inju­ry. Pyru­vate (CH3­COCOO-), a ­small mole­cule ­that is nor­mal­ly regard­ed as a key inter­me­di­ate in the oxi­da­tive or anaer­o­bic metab­olism of glu­cose, is ­also a ­potent and effec­tive ROS scav­en­ger. Unfor­tu­nate­ly, the use­ful­ness of pyru­vate as a ther­a­peu­tic ­agent is abro­gat­ed by its ­very ­poor stabil­ity in solu­tion. In an ­effort to ­take advan­tage of the abil­ity of pyru­vate to scav­enge ROS ­while avoid­ing the prob­lems asso­ciat­ed ­with the instabil­ity of pyru­vate in solu­tion, we ­have devel­oped a nov­el resus­ci­ta­tion ­fluid, ­which con­sists of a sim­ple deriv­a­tive of pyru­vic ­acid, ­ethyl pyru­vate, dis­solved in a cal­cium-con­tain­ing bal­anced ­salt solu­tion. We ­call ­this solu­tion ­Ringer’s ­Ethyl Pyru­vate Solu­tion (­REPS), and ­have ­shown in pre­lim­i­nary stud­ies ­that treat­ment ­with ­REPS can ­improve out­come in a varie­ty of ani­mal mod­els of crit­i­cal ill­ness.

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