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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

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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